Respiratory pathophysiology of panic disorder : An ambulatory monitoring study

• Objective: To assess the external validity of laboratory baselines in panic disorder (PD), frequently associated with respiratory pattern abnormalities like increased respiratory variability and sighing, implying a stable pathophysiologic trait characteristic. METHODS:: Physical activity and a variety of breath-by-breath volumetric, timing, and variability measures of respiration were recorded in the daily life of 26 patients with PD and 26 healthy controls (HC), using a novel ambulatory monitoring system optimized for reliable assessment of respiratory pattern. Data were stratified for physical activity to eliminate its confounding effects. RESULTS:: Groups showed strong and consistent diurnal patterns in almost all respiratory variables. However, patients with PD did not differ from HC regarding any of the respiratory timing, volumetric and variability measures, with negligible group effect sizes for all measures. Patients with fewer self-reported respiratory symptoms of anxiety exhibited more pronounced rapid shallow breathing as well as diminished total breath time and its variability. CONCLUSIONS:: Despite state-of-the-art ambulatory assessment and sufficient statistical power to detect respiratory alterations previously observed in the laboratory, we found no evidence for such alterations in PD patients’ daily life. Neither the total PD group nor patients with particularly pronounced respiratory symptomatology displayed increased respiratory variability. These results caution against interpreting results from laboratory baselines in PD as reflecting a stable trait characteristic. Rather, they likely represent a state-trait interaction due to enhanced reactivity of PD patients to novel environments. These results challenge aspects of respiratory theories of PD that were based on laboratory findings. Copyright © 2009 by the American Psychosomatic Society.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Psykiatri (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Psychiatry (hsv//eng)

Nyckelord

adult

ambulatory monitoring

anxiety

article

breathing

circadian rhythm

clinical article

controlled study

daily life activity

human

panic

pathophysiology

physical activity

priority journal

psychologic assessment

respiratory function

volumetry

Activities of Daily Living

Adult

Anxiety Disorders

Biological Markers

Circadian Rhythm

Combat Disorders

Data Collection

Female

Humans

Male

Monitoring

Ambulatory

Motor Activity

Panic Disorder

Personality Inventory

Questionnaires

Reproducibility of Results

Respiration

Respiration Disorders

Respiratory Function Tests

Respiratory System

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)