Suffocation and respiratory responses to carbon dioxide and breath holding challenges in individuals with panic disorder.
OBJECTIVE
Findings showing that individuals with panic disorder (PD) are prone to experience panic attacks when inhaling CO2-enriched air have given rise to the hypothesis that physiological systems underlying the experience of suffocation may be important in the etiology of PD. In this study, we tested several predictions stemming from this view.


METHODS
Forty individuals with PD and 32 controls underwent both a breath-holding challenge and a CO2 rebreathing challenge. A wide array of physiological and psychological responses, including continuous measurements of subjective suffocation, was recorded.


RESULTS
Individuals with PD experienced elevated physiological reactivity to both challenges and greater levels of suffocation sensations during the rebreathing challenge. Furthermore, PD individuals who experienced a panic attack in response to the rebreathing challenge exhibited faster but shallower breathing during the challenge than did other PD individuals.


CONCLUSIONS
Findings are consistent with theories linking PD to hypersensitive brain systems underlying the experience of suffocation. The possibility that subjective suffocation was in part mediated by peripheral interoceptive disturbances (vs. brainstem dysregulation) is discussed.
Rassovsky
Yuri
Y
Department of Psychology, University of Minnesota, United States. yurir@ucla.edu
Abrams
Kenneth
K
Kushner
Matt G
MG
D000328:Adult; D001237:Asphyxia / Q000378:metabolism*; D002245:Carbon Dioxide / Q000378:metabolism*; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000175:diagnosis / Q000378:metabolism* / Q000523:psychology; D012119:Respiration; D012720:Severity of Illness Index
D002245:Carbon Dioxide