Bouwer C, Stein D J
Department of Psychiatry, Faculty of Medicine, University of Stellenbosch, Tygerberg, South Africa.
Am J Psychiatry. 1997 Nov;154(11):1566-70. doi: 10.1176/ajp.154.11.1566.
An important recent hypothesis suggests that panic disorder results from a false suffocation alarm. However, the association of panic disorder with a history of traumatic suffocation experiences (e.g., near-drowning and near-choking) has not been well studied. This study examined whether a history of traumatic suffocation might be more common in patients with panic disorder who have predominantly respiratory symptoms.
Patients with panic disorder (N = 176) and psychiatric comparison subjects (N = 60) were questioned about a history of traumatic suffocation experiences. The panic disorder patients were classified as having predominantly respiratory, cardiovascular, occulovestibular, or gastrointestinal symptoms in order to determine a possible association between traumatic suffocation and symptom subtype.
The frequency of traumatic suffocation was significantly higher among the panic disorder patients (19.3%) than among the comparison subjects (6.7%). Within the panic disorder group, patients with a history of traumatic suffocation were significantly more likely to exhibit predominantly respiratory symptoms and nocturnal panic attacks, while patients without such a history were significantly more likely to have predominantly cardiovascular symptoms, occulovestibular symptoms, and agoraphobia.
There may be a specific association between panic disorder and a history of traumatic suffocation, and such a history in turn appears associated with predominantly respiratory symptoms and nocturnal panic attacks. Although additional studies are needed to confirm these data, a history of traumatic suffocation might be hypothesized to play a role in the etiology of panic disorder in some patients and may provide a useful window on understanding the psychobiology of this disorder.
最近一个重要的假说是惊恐障碍源于错误的窒息警报。然而，惊恐障碍与创伤性窒息经历史（如溺水濒死和窒息濒死）之间的关联尚未得到充分研究。本研究调查了在以呼吸道症状为主的惊恐障碍患者中，创伤性窒息史是否更为常见。
对惊恐障碍患者（N = 176）和精神科对照受试者（N = 60）询问创伤性窒息经历史。将惊恐障碍患者分为以呼吸道、心血管、眼前庭或胃肠道症状为主，以确定创伤性窒息与症状亚型之间可能存在的关联。
惊恐障碍患者中创伤性窒息的发生率（19.3%）显著高于对照受试者（6.7%）。在惊恐障碍组中，有创伤性窒息史的患者更有可能主要表现为呼吸道症状和夜间惊恐发作，而无此类病史的患者更有可能主要表现为心血管症状、眼前庭症状和广场恐惧症。
惊恐障碍与创伤性窒息史之间可能存在特定关联，而这种病史反过来似乎与主要的呼吸道症状和夜间惊恐发作有关。尽管需要更多研究来证实这些数据，但可以推测创伤性窒息史在某些患者惊恐障碍的病因中起作用，并可能为理解该障碍的心理生物学提供一个有用的窗口。
