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Do Panic Symptom Profiles Influence Response to a Hypoxic Challenge in Patients With Panic Disorder? A Preliminary Report

From the Departments of Psychology (J.G.B., J.C.S.) and Physical Therapy, Exercise, and Nutrition Sciences (P.J.O.), State University of New York, Buffalo, NY.

Address reprint requests to: J. Gayle Beck, PhD, Department of Psychology, 230 Park Hall, State University of New York, Buffalo, NY 14260. Email: jgbeck{at}acsu.buffalo.edu

OBJECTIVE: This study examined how panic symptom profiles affect response to a hypo-ic laboratory challenge in patients with panic disorder.

METHODS: Seven patients whose naturally occurring panic attacks were characterized by prominent respiratory symptoms (Resp subgroup) were compared and contrasted with seven patients who did not report respiratory symptoms during panic attacks (NonResp subgroup). All were administered a novel 12% O₂ challenge and assessed with measures of tidal volume, respiratory rate, end-tidal CO₂, anxiety, and panic symptoms.

RESULTS: Although the Resp and NonResp subgroups showed equivalent increases in an-iety and panic symptoms, the Resp subgroup showed greater fluctuation in tidal volume during and after the challenge as well as overall lower levels of end-tidal CO₂.

CONCLUSIONS: Our results suggest the importance of panic symptom profiles in determining respiratory responses to a hypo-ic challenge in patients with panic disorder. These findings are discussed in light of current theories of panic disorder, with particular attention to respiratory disturbances in this disorder.

Key Words: panic disorder • respiration • hypoxia • anxiety.

Abbreviations: ADIS-IV = Anxiety Disorders Interview Schedule-IV; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, fourth edition; DSQ = Diagnostic Symptom Questionnaire; ES = effect size; NonResp = nonrespiratory subgroup; PD = panic disorder; PetCO₂ = end-tidal CO₂; Resp = respiratory subgroup; RR = respiration rate; V_T = tidal volume.

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