Association of panic disorder with a history of traumatic suffocation.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Bouwer
C
C
Department of Psychiatry, Faculty of Medicine, University of Stellenbosch, Tygerberg, South Africa.
Stein
D J
DJ
D000328:Adult; D017668:Age of Onset; D000379:Agoraphobia / Q000175:diagnosis / Q000453:epidemiology; D000402:Airway Obstruction / Q000175:diagnosis / Q000453:epidemiology; D001237:Asphyxia / Q000175:diagnosis / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D015701:Near Drowning / Q000175:diagnosis / Q000453:epidemiology*; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D011569:Psychiatric Status Rating Scales; D014104:Torture