Respiratory psychophysiology of panic disorder: three respiratory challenges in 98 subjects.
Respiratory psychophysiology of panic disorder: three respiratory challenges in 98 subjects.
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恐慌症的呼吸心理生理学：98 名受试者的三种呼吸挑战。
DOI：
10.1176/ajp.154.11.1557
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Gorman,JM
中科院分区：
文献类型：
--
作者：
Papp,LA;Martinez,JM;Klein,DF;Coplan,JD;Norman,RG;Cole,R;deJesus,MJ;Ross,D;Goetz,R;Gorman,JM
呼吸系统异常可能在惊恐障碍的病理生理学中起中心作用。本研究采用改良的方法，对59名DSM-III-R惊恐障碍患者和39名正常志愿者进行了3次呼吸激发试验，以检测迄今为止最大的一组受试者的呼吸反应。CO2吸入和室内空气过度通气通过连续肺功能测定的室内空气呼吸分开。二氧化碳比正常受试者更容易产生焦虑，而且二氧化碳比过度换气更容易引起恐慌。在吸入CO2期间，患者的呼吸频率比对照组增加得更快，这种增加发生在惊恐发作之前。对5%CO2产生恐慌反应的患者表现出潮气末CO2持续升高，而对照组潮气末CO2稳定。呼气末CO2较低和基线时分钟通气量变化较大可预测吸入CO2时的惊恐发作。CO2或过度通气的挑战，呼吸率急剧下降，而潮气量保持升高的时间比在controllingsubjects. CONCLUSIONSTHESS的研究结果证实了更大的行为和生理敏感性的恐慌症患者的CO2吸入，并确定了一系列的呼吸异常。惊恐障碍的惊恐发作可能是由于代偿机制的无效，主要是呼吸频率。(Am J Psychiatry 1997; 154：1557-1565）
OBJECTIVERespiratory abnormalities may play a central role in the pathophysiology of panic disorder. The current study was undertaken to examine the respiratory response in the largest series of subjects to date during three respiratory challenges that used improved methodology.METHODFifty-nine patients with DSM-III-R panic disorder and 39 normal volunteers were challenged with 5% and 7% CO2inhalation and room air hyperventilation separated by room air breathing with continuous spirometry.RESULTSPatients with panic disorder were more sensitive to the anxiogenic effects of CO2than were normal subjects, and CO2was a more potent stimulus to panic than hyperventilation. Patients increased their respiratory rate more quickly during CO2inhalation than did comparison subjects, and this increase preceded the panic attacks. Patients who panicked in response to 5% CO2demonstrated continued rise in end-tidal CO2, while the end-tidal CO2of the comparison groups stabilized. Low end-tidal CO2and high variance in minute ventilation at baseline predicted panic attacks during CO2inhalation. Following CO2or hyperventilation challenges, respiratory rate dropped sharply, while tidal volume remained elevated longer in patients than in comparison subjects.CONCLUSIONSThe findings confirm the greater behavioral and physiological sensitivity of patients with panic disorder to CO2inhalation and identify a series of respiratory abnormalities. Panic attacks in panic disorder may be explained by inefficient compensatory mechanisms, primarily of respiratory rate. (Am J Psychiatry 1997; 154:1557–1565)