Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-22T23:22:06.541Z Has data issue: false hasContentIssue false

Symptom profiles of natural and laboratory panic attacks

Published online by Cambridge University Press:  24 June 2014

K R J Schruers*
Affiliation:
Department of Psychiatry and Neuropsychology and Vijverdal Academic Anxiety Center, Maastricht University, Maastricht, the Netherlands
H van de Mortel
Affiliation:
Department of Psychiatry and Neuropsychology and Vijverdal Academic Anxiety Center, Maastricht University, Maastricht, the Netherlands
T Overbeek
Affiliation:
Department of Psychiatry and Neuropsychology and Vijverdal Academic Anxiety Center, Maastricht University, Maastricht, the Netherlands
E Griez
Affiliation:
Department of Psychiatry and Neuropsychology and Vijverdal Academic Anxiety Center, Maastricht University, Maastricht, the Netherlands
*
Department of Psychiatry and Neuropsychology and Vijverdal Academic Anxiety Center, Maastricht University, PO Box 88, 6200 AB Maastricht, the Netherlands. Tel: 0031 43 3685330; Fax: 0031 43 3685331; E-mail: [email protected]

Abstract

Background:

Little accurate information is available about the symptomatology of real-life panic attacks and about how well they are reproduced by an experimental model such as the 35% CO2 challenge.

Method:

Real-life panic symptoms were assessed in a group of 67 panic disorder patients, using daily life monitoring. Panic symptoms elicited by a 35% CO2 challenge were assessed in 61 panic disorder patients, and their frequency was compared with the real-life symptoms.

Results:

The most frequent real-life symptoms were palpitations, dizziness and trembling. The 35% CO2 challenge reproduced well the majority of real-life symptoms.

Conclusion:

The findings suggest that the 35% CO2 challenge is a marker for spontaneous panic attacks, which are considered the core of panic disorder.

Type
Research Article
Copyright
Copyright © 2004 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Dick, CI, Bland, RC, Newman, SC. Epidemiology of psychiatric disorders in Edmonton. Panic disorder. Acta Psychiatr Scand 1994;90(Suppl 376):4553. CrossRefGoogle Scholar
Vollrath, M, Koch, R, Angst, J. The Zurich Study. IX. Panic disorder and sporadic panic: symptoms, diagnosis, prevalence, and overlap with depression. Eur Arch Psychiatry Neurol Sci 1990;239: 221230.CrossRefGoogle ScholarPubMed
Briggs, AC, Stretch, DD, Brandon, S. Subtyping of panic disorder by symptom profile. Br J Psychiatry 1993;163: 201209.CrossRefGoogle ScholarPubMed
Shioiri, T, Someya, T, Murashita, J, Takahashi, S. The symptom structure of panic disorder: a trial using factor and cluster analysis. Acta Psychiatr Scand 1996;93: 8086.CrossRefGoogle ScholarPubMed
de Beurs, E, Garssen, B, Bouikhuisen, M, Lange, A, Van Balkom, A, Van Dyck, R. Continuous monitoring of panic. Acta Psychiatr Scand 1994;90: 3845.CrossRefGoogle Scholar
Guttmacher, LB, Murphy, DL, Insel, TR. Pharmacologic models of anxiety. Compr Psychiatry 1983;24: 312326.CrossRefGoogle ScholarPubMed
Uhde, TW, Tancer, ME. Chemical models of panic: a review and critique. In: Tyrer, P (ed). Psychopharmacology of anxiety. Oxford, UK: Oxford University Press,1990. Google Scholar
Verburg, K, Perna, G, Bellodi, L, Griez, E. The 35% panic provocation challenge as a diagnostic test for panic disorder. In: Bellodi, L, Perna, G (eds). The panic respiration connection. Milan, Italy: Medical Media Srl, 1998. Google Scholar
Verburg, K, Klaassen, T, Pols, H, Griez, E. Comorbid depressive disorder increases vulnerability to the 35% carbon dioxide (CO2) challenge in panic disorder patients. J Affect Disord 1998;49: 195201.CrossRefGoogle Scholar
Griez, E, De Loof, C, Pols, H, Zandbergen, J, Lousberg, H. Specific sensitivity of patients with panic attacks to carbon dioxide inhalation. Psychiatry Res 1990;31: 193199.CrossRefGoogle ScholarPubMed
Verburg, K, Pols, H, De LeeuwM, , Griez, E. Reliability of the 35% carbon dioxide panic provocation challenge. Psychiatry Res 1998;78: 207214.CrossRefGoogle ScholarPubMed
Verburg, K, Griez, E, Meijer, J. A 35% carbon dioxide challenge in simple phobias. Acta Psychiatr Scand 1994;90: 420423.CrossRefGoogle ScholarPubMed
Verburg, K, Griez, E, Meijer, J, Pols, H. Discrimination between panic disorder and generalized anxiety disorder by 35% carbon dioxide challenge. Am J Psychiatry 1995;152: 10811083.Google ScholarPubMed
Caldirola, D, Perna, G, Arancio, C, Bertani, A, Bellodi, L. The 35% CO2 challenge test in patients with social phobia. Psychiatry Res 1997;71: 4148.CrossRefGoogle ScholarPubMed
Gorman, JM, Papp, LA, Martinez, Jet al. High dose carbon dioxide challenge test in anxiety disorder patients. Biol Psychiatry 1990;28: 743757.CrossRefGoogle ScholarPubMed
Papp, LA, Klein, DF, Martinez, Jet al. Diagnostic and substance specificity of carbon-dioxide-induced panic. Am J Psychiatry 1993;150: 250257.Google ScholarPubMed
Perna, G, Gabriele, A, Caldirola, D, Bellodi, L. Hypersensitivity to inhalation of carbon dioxide and panic attacks. Psychiatry Res 1995;57: 267273.CrossRefGoogle ScholarPubMed
Perna, G, Battaglia, M, Garberi, A, Arancio, C, Bertani, A, Bellodi, L. 35% CO2/65% O2 inhalation test in panic patients. Psychiatry Res 1994;52: 159172.CrossRefGoogle Scholar
Perna, G, Bertani, A, Gabriele, A, Politi, E, Bellodi, L. Modification of 35% carbon dioxide hypersensitivity across one week of treatment with clomipramine and fluvoxamine: a double-blind, randomized, placebo-controlled study. J Clin Psychopharmacol 1997;17: 173178.CrossRefGoogle ScholarPubMed
Bertani, A, Perna, G, Arancio, C, Caldirola, D, Bellodi, L. Pharmacologic effect of imipramine, paroxetine, and sertraline on 35% carbon dioxide hypersensitivity in panic patients: a double-blind, random, placebo-controlled study. J Clin Psychopharmacol 1997;17: 97101.CrossRefGoogle ScholarPubMed
Schmidt, NB, Trakowski, JH, Staab, JP. Extinction of panicogenic effects of a 35% CO2 challenge in patients with panic disorder. J Abnorm Psychol 1997;106: 630638.CrossRefGoogle ScholarPubMed
Van den Hout, MA, Van der Molen, GM, Griez, E, Lousberg, H, Jansen, A. Reduction of CO2-induced anxiety in patients with panic attacks after repeated CO2 exposure. Am J Psychiatry 1987;144: 788791.Google ScholarPubMed
Pols, H, Zandbergen, J, De Loof, C, Griez, E. Attenuation of carbon dioxide-induced panic after clonazepam treatment. Acta Psychiatr Scand 1991;84: 585586.CrossRefGoogle ScholarPubMed
Pols, H, Lousberg, H, Zandbergen, J, Griez, E. Panic disorder patients show decrease in ventilatory response to CO2 after clomipramine treatment. Psychiatry Res 1993;47: 295296.CrossRefGoogle ScholarPubMed
Pols, HJ, Hauzer, RC, Meijer, JA, Verburg, K, Griez, EJ. Fluvoxamine attenuates panic induced by 35% CO2 challenge. J Clin Psychiatry 1996;57: 539542.CrossRefGoogle ScholarPubMed
Gorman, JM, Browne, ST, Papp, LAet al. Effect of antipanic treatment on response to carbon dioxide. Biol Psychiatry 1997;42: 982991.CrossRefGoogle ScholarPubMed
Nardi, AE, Valenca, AM, Zin, WA, Figuiera, I, Marques, C, Versiassi, M. Short term clonezepam treatment in carbon dioxide induced panic attacks. J Bras Psig 1997;46: 611614. Google Scholar
Bocola, V, Trecco, MD, Fabbrini, G, Paladini, C, Sollecito, A, Martucci, N. Antipanic effect of fluoxetine measured by CO2 challenge test. Biol Psychiatry 1998;43: 612615.CrossRefGoogle ScholarPubMed
Griez, EJ, Lousberg, H, van den Hout, MA, van der Molen, GM. CO2 vulnerability in panic disorder. Psychiatry Res 1987;20: 97105.CrossRefGoogle ScholarPubMed
De Loof, C, Zandbergen, J, Griez, E. Are there differences between naturally occuring and provoked panic attacks? The case of carbon dioxide induced panic attacks. In: Soldates, C, Rabavilles, A (eds). Psychiatry today. Amsterdam, The Netherlands: Elsevier science publishers, 1990. Google Scholar
Klaassen, T, Klumperbeek, J, Deutz, NE, Van Praag, HM, Griez, E. Effects of tryptophan depletion on anxiety and on panic provoked by carbon dioxide challenge. Psychiatry Res 1998;77: 167174.CrossRefGoogle ScholarPubMed
Argyle, N, Roth, M. The definition of panic attacks, Part I. Psychiatr Dev 1989;7: 175186.Google ScholarPubMed
Beitman, BD, Basha, I, Flaker, Get al. Atypical or nonanginal chest pain. Panic disorder or coronary artery disease? Arch Intern Med 1987;147: 15481552.CrossRefGoogle ScholarPubMed
Serlie, AW, Erdman, RA, Passchier, J, Trijsburg, RW, Ten Cate, FJ. Psychological aspects of non-cardiac chest pain. Psychother Psychosom 1995;64: 6273.CrossRefGoogle ScholarPubMed
Fleet, RP, Dupuis, G, Marchand, A, Burelle, D, Arsenault, A, Beitman, BD. Panic disorder in emergency department chest pain patients: prevalence, comorbidity, suicidal ideation, and physician recognition. Am J Med 1996;101: 371380.CrossRefGoogle ScholarPubMed
Fleet, RP, Beitman, BD. Unexplained chest pain: when is it panic disorder? Clin Cardiol 1997;20: 187194.CrossRefGoogle ScholarPubMed
Kuijpers, PM, Honig, A, Griez, EJ, Braat, SH, Wellens, HJ. Paniekstoornissen, pijn op de borst en palpitaties: een pilotonderzoek op een Nederlandse Eerste Harthulp. Ned Tijdschr Geneeskd 2000;144: 745749.Google Scholar
Schruers, K, Kuijpers, PM, Honig, A, Griez, E. Panic symptoms determine type of health care. Poster at the 14th conference of the European Health Psychology Society, Leiden, The Netherlands, 1619 August 2000. Google Scholar
Biber, B, Alkin, T. Panic disorder subtypes: differential responses to CO2 challenge. Am J Psychiatry 1999;156: 739744.CrossRefGoogle ScholarPubMed
Cassano, GB, Petracca, A, Perugi, G, Toni, C, Tundo, A, Roth, M. Derealization and panic attacks: a clinical evaluation on 150 patients with panic disorder/agoraphobia. Compr Psychiatry 1989;30: 512.CrossRefGoogle ScholarPubMed
Mavissakalian, MR, Perel, JM. The relationship of plasma imipramine and N-desmethylimipramine to response in panic disorder. Psychopharmacol Bull 1996;32: 143147.Google ScholarPubMed
Koszycki, D, Bradwejn, J, Bourin, M. Comparison of the effects of cholecystokinin-tetrapeptide and carbon dioxide in health volunteers. Eur Neuropsychopharmacol 1991;1: 137141.CrossRefGoogle ScholarPubMed
Perna, G, Battaglia, M, Garberi, A, Arancio, C, Bertani, A, Bellodi, L. 35% CO2/65% O2 inhalation test in panic patients. Psychiatry Res 1994;52: 159172.CrossRefGoogle Scholar
Klein, DF. False suffocation alarms, spontaneous panics, and related conditions. An integrative hypothesis. Arch Gen Psychiatry 1993;50: 306317.CrossRefGoogle ScholarPubMed