title: Impact of Panic Attacks on Bronchoconstriction and Subjective Distress in Asthma Patients With and Without Panic Disorder.
abstract: OBJECTIVE
  Panic disorder (PD) is common among asthma patients and is associated with worse asthma outcomes. This may occur because of psychophysiological factors or cognitive/affective factors. This study evaluated the impact of panic attacks (PAs) on bronchoconstriction and subjective distress in people who have asthma with and without PD.
  
  
  METHODS
  A total of 25 asthma patients (15 with PD who had a PA [PD/PA], 10 without PD who did not have a PA [no PD/no PA]) were recruited from an outpatient clinic. They underwent a panic challenge (one vital capacity inhalation of 35% carbon dioxide [CO2]) and completed the Panic Symptom Scale, the Subjective Distress Visual Analogue Scale, and the Borg Scale before and after CO2. Forced expiratory volume in 1 second was assessed pre- and post-CO2; respiratory (i.e., CO2 production, minute ventilation, tidal volume) was continuously recorded, and physiological measures (i.e., systolic and diastolic blood pressure [SBP/DBP]) were recorded every 2 minutes.
  
  
  RESULTS
  Analyses adjusting for age, sex, and provocative concentration of methacholine revealed no significant differences between groups in forced expiratory volume in 1 second change after CO2 inhalation (F(1, 23) < 0.01, p = .961). However, patients with PD/PA reported more panic (F(1, 22) = 18.10, p < .001), anxiety (F(1, 22) = 21.93, p < .001), worry (F(1, 22) = 26.31, p < .001), and dyspnea (F(1,22) = 4.68, p = .042) and exhibited higher levels of CO2 production (F(1, 2843) = 5.89, p = .015), minute ventilation (F(1, 2844) = 4.48, p = .034), and tidal volume (F(1, 2844) = 4.62, p = .032) after the CO2 challenge, compared with patients with no PD/no PA.
  
  
  CONCLUSIONS
  Results, presented as hypothesis generating, suggest that asthma patients with PD/PA exhibit increased panic-like anxiety, breathlessness, and a respiratory pattern consistent with hyperventilation that was not linked to statistically significant drops in bronchoconstriction.
authors.affiliation: From the Montreal Behavioural Medicine Centre (Boudreau, Bacon, Paine, Trutschnigg, Morizio, Lavoie), Hôpital du Sacré-Cœur de Montréal-CIUSSS-NIM, Montréal, Québec, Canada; Department of Psychology (Boudreau, Lavoie), University of Quebec at Montreal, Montreal, Quebec, Canada; Department of Exercise Science (Bacon, Paine, Morizio), Concordia University, Montreal, Quebec, Canada; and Research Center (Boudreau, Bacon, Cartier, Trutschnigg, Lavoie), Hôpital du Sacré-Coeur de Montréal-CIUSSS-NIM, Montréal, Québec, Canada.
authors.forename: Maxine
authors.initials: M
authors.lastname: Boudreau
authors.forename: Simon L
authors.initials: SL
authors.lastname: Bacon
authors.forename: Nicola J
authors.initials: NJ
authors.lastname: Paine
authors.forename: André
authors.initials: A
authors.lastname: Cartier
authors.forename: Barbara
authors.initials: B
authors.lastname: Trutschnigg
authors.forename: Alexandre
authors.initials: A
authors.lastname: Morizio
authors.forename: Kim L
authors.initials: KL
authors.lastname: Lavoie
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000209:etiology / Q000503:physiopathology*; D016084:Bronchoconstriction / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000150:complications / Q000503:physiopathology*