title: Comparison between hyperventilation and breath-holding in panic disorder: patients responsive and non-responsive to both tests.
abstract: Our aim was to compare the demographic and psychopathological features of panic disorder (PD) patients who underwent hyperventilation and breath-holding challenge tests, and to describe the features of patients who had a panic attack after both tests versus those patients who did not experience panic after either test. Eighty-five PD patients were induced to hyperventilate (30 breaths/min) for 4 min, and a week later to hold their breath for as long as possible four times with a 2-min interval in between. Anxiety scales were applied before and after the tests. Patients who responded with a panic attack to both tests (BPA, n = 25) were compared with patients who experienced spontaneous panic attacks but did not panic in response to the two tests (NPA, n = 16). The BPA group had a significantly higher presence of respiratory symptoms during a panic attack. The criteria for the respiratory PD subtype were fulfilled in 18 (72.0%) BPA patients and in 6 (37.5%) NPA patients. The BPA patients had a later onset of panic disorder and a higher familial prevalence of PD. Our data suggest that there is a distinction between PD patients who were sensitive to both hyperventilation and breath-holding tests and PD patients who were not affected by the challenge tests. The panic attack may be a final common pathway for different types of stimuli, and respiratory tests may characterize different PD subgroups.
authors.affiliation: Laboratory of Panic and Respiration, Federal University of Rio de Janeiro, Brazil. antonionardi@terra.com.br
authors.forename: Antonio E
authors.initials: AE
authors.lastname: Nardi
authors.forename: Alexandre M
authors.initials: AM
authors.lastname: Valença
authors.forename: Marco A
authors.initials: MA
authors.lastname: Mezzasalma
authors.forename: Sandra P
authors.initials: SP
authors.lastname: Levy
authors.forename: Fabiana L
authors.initials: FL
authors.lastname: Lopes
authors.forename: Isabella
authors.initials: I
authors.lastname: Nascimento
authors.forename: Rafael C
authors.initials: RC
authors.lastname: Freire
authors.forename: Andre B
authors.initials: AB
authors.lastname: Veras
authors.forename: Walter A
authors.initials: WA
authors.lastname: Zin
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D006985:Hyperventilation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010200:Panic; D016584:Panic Disorder / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D012119:Respiration; D012307:Risk Factors; D012680:Sensitivity and Specificity