Epinephrine and fear of bodily sensations in panic disorder and social phobia.
Fear of bodily symptoms of arousal has been implicated in the pathogenesis of both spontaneously occurring and experimentally provoked panic. Fear of bodily symptoms may be characteristic for panic disorder (PD) and is hypothesized to predict state anxiety and panic frequency during experimentally induced peripheral arousal. Twenty-eight subjects, 14 with PD and 14 with social phobia (SP) were infused with placebo and epinephrine (20, 40 and 80 ng/kg bodyweight/min) according to a fixed schedule in a single blind design. Fear of bodily symptoms was higher in subjects with PD, who also reported more bodily symptoms and higher state anxiety scores during the experiment. The panic rate (five out of 14), however, was the same in both groups. Panickers did not differ from non-panickers in trait- or baseline measures except for fear of bodily symptoms, which was marginally higher in panickers. Panickers showed greater reactivity in heart rate, diastolic blood pressure and capillary PCO(2). Our data do not support the hypothesis of a major role for fear of bodily symptoms in epinephrine-induced panic. Also, our results do not demonstrate a different reaction to epinephrine in PD and SP with situational panic attacks.
Department of Psychiatry, Vrije Universiteit, Amsterdam, The Netherlands.
D J
DJ
Veltman
G
G
van Zijderveld
F J
FJ
Tilders
R
R
van Dyck