Carbon dioxide hypersensitivity, hyperventilation, and panic disorder
OBJECTIVE: The purpose of this article is to offer a comprehensive, data-based explanation of the relationship between hyperventilation and panic disorder linking CO2 hypersensitivity, cognitive/behavioral factors, and the respiratory effects of antipanic pharmacologic and psychological treatments....
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| Veröffentlicht in: | The American journal of psychiatry 1993-08, Vol.150 (8), p.1149-1157 |
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| container_title | The American journal of psychiatry |
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| creator | PAPP, L. A KLEIN, D. F GORMAN, J. M |
| description | OBJECTIVE: The purpose of this article is to offer a comprehensive,
data-based explanation of the relationship between hyperventilation and
panic disorder linking CO2 hypersensitivity, cognitive/behavioral factors,
and the respiratory effects of antipanic pharmacologic and psychological
treatments. METHOD: The authors conducted a computerized search of MEDLINE
for relevant articles. RESULTS: Some panic patients have a chronic, subtle
respiratory disturbance. Acute hyperventilation is neither necessary nor
sufficient for panic to occur. Respiratory abnormalities in panic patients
may adaptively aim at coping with a hypersensitive CO2 chemoreceptor
system. Pharmacologic panicogens also stimulate the respiratory system,
causing hyperventilation. Triggering this hypersensitive respiratory
control mechanism may incite panic. Antipanic medications may reset the
receptor threshold. Misattribution and catastrophic interpretation of
somatic symptoms or the sense of loss of control may contribute to panic
symptoms. Behavioral interventions such as desensitization or breathing
retraining may block the full-blown attack. Cognitive strategies through
cognitive control of respiration may supplement and accentuate these
interventions. CONCLUSIONS: Panic disorder may be due to an inherently
unstable autonomic nervous system, coupled with cognitive distress. |
| doi_str_mv | 10.1176/ajp.150.8.1149 |
| format | Article |
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data-based explanation of the relationship between hyperventilation and
panic disorder linking CO2 hypersensitivity, cognitive/behavioral factors,
and the respiratory effects of antipanic pharmacologic and psychological
treatments. METHOD: The authors conducted a computerized search of MEDLINE
for relevant articles. RESULTS: Some panic patients have a chronic, subtle
respiratory disturbance. Acute hyperventilation is neither necessary nor
sufficient for panic to occur. Respiratory abnormalities in panic patients
may adaptively aim at coping with a hypersensitive CO2 chemoreceptor
system. Pharmacologic panicogens also stimulate the respiratory system,
causing hyperventilation. Triggering this hypersensitive respiratory
control mechanism may incite panic. Antipanic medications may reset the
receptor threshold. Misattribution and catastrophic interpretation of
somatic symptoms or the sense of loss of control may contribute to panic
symptoms. Behavioral interventions such as desensitization or breathing
retraining may block the full-blown attack. Cognitive strategies through
cognitive control of respiration may supplement and accentuate these
interventions. CONCLUSIONS: Panic disorder may be due to an inherently
unstable autonomic nervous system, coupled with cognitive distress.</description><identifier>ISSN: 0002-953X</identifier><identifier>EISSN: 1535-7228</identifier><identifier>DOI: 10.1176/ajp.150.8.1149</identifier><identifier>PMID: 8392296</identifier><identifier>CODEN: AJPSAO</identifier><language>eng</language><publisher>Washington, DC: American Psychiatric Publishing</publisher><subject>Adult and adolescent clinical studies ; Alkalosis, Respiratory - chemically induced ; Alkalosis, Respiratory - complications ; Anxiety disorders. Neuroses ; Biological and medical sciences ; Carbon dioxide ; Carbon Dioxide - adverse effects ; Cognitive Therapy ; Humans ; Hyperventilation ; Hyperventilation - chemically induced ; Hyperventilation - complications ; Lactates - pharmacology ; Lactic Acid ; Medical disorders ; Medical sciences ; Neuroses ; Panic Disorder - etiology ; Panic Disorder - physiopathology ; Panic Disorder - therapy ; Panic disorders ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Receptors, Cell Surface - drug effects ; Receptors, Cell Surface - physiology ; Relationship ; Respiratory Center - drug effects ; Respiratory Center - physiopathology ; Respiratory system ; Social research</subject><ispartof>The American journal of psychiatry, 1993-08, Vol.150 (8), p.1149-1157</ispartof><rights>1993 INIST-CNRS</rights><rights>Copyright American Psychiatric Association Aug 1993</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a441t-eb1200238968ed539e4b97d69070591d60a5152dd8baa3de4daa7608bd4e53d43</citedby><cites>FETCH-LOGICAL-a441t-eb1200238968ed539e4b97d69070591d60a5152dd8baa3de4daa7608bd4e53d43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://psychiatryonline.org/doi/epdf/10.1176/ajp.150.8.1149$$EPDF$$P50$$Gappi$$H</linktopdf><linktohtml>$$Uhttps://psychiatryonline.org/doi/full/10.1176/ajp.150.8.1149$$EHTML$$P50$$Gappi$$H</linktohtml><link.rule.ids>314,780,784,2859,21629,27869,27924,27925,31000,77791,77792</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4828431$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8392296$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>PAPP, L. A</creatorcontrib><creatorcontrib>KLEIN, D. F</creatorcontrib><creatorcontrib>GORMAN, J. M</creatorcontrib><title>Carbon dioxide hypersensitivity, hyperventilation, and panic disorder</title><title>The American journal of psychiatry</title><addtitle>Am J Psychiatry</addtitle><description>OBJECTIVE: The purpose of this article is to offer a comprehensive,
data-based explanation of the relationship between hyperventilation and
panic disorder linking CO2 hypersensitivity, cognitive/behavioral factors,
and the respiratory effects of antipanic pharmacologic and psychological
treatments. METHOD: The authors conducted a computerized search of MEDLINE
for relevant articles. RESULTS: Some panic patients have a chronic, subtle
respiratory disturbance. Acute hyperventilation is neither necessary nor
sufficient for panic to occur. Respiratory abnormalities in panic patients
may adaptively aim at coping with a hypersensitive CO2 chemoreceptor
system. Pharmacologic panicogens also stimulate the respiratory system,
causing hyperventilation. Triggering this hypersensitive respiratory
control mechanism may incite panic. Antipanic medications may reset the
receptor threshold. Misattribution and catastrophic interpretation of
somatic symptoms or the sense of loss of control may contribute to panic
symptoms. Behavioral interventions such as desensitization or breathing
retraining may block the full-blown attack. Cognitive strategies through
cognitive control of respiration may supplement and accentuate these
interventions. CONCLUSIONS: Panic disorder may be due to an inherently
unstable autonomic nervous system, coupled with cognitive distress.</description><subject>Adult and adolescent clinical studies</subject><subject>Alkalosis, Respiratory - chemically induced</subject><subject>Alkalosis, Respiratory - complications</subject><subject>Anxiety disorders. Neuroses</subject><subject>Biological and medical sciences</subject><subject>Carbon dioxide</subject><subject>Carbon Dioxide - adverse effects</subject><subject>Cognitive Therapy</subject><subject>Humans</subject><subject>Hyperventilation</subject><subject>Hyperventilation - chemically induced</subject><subject>Hyperventilation - complications</subject><subject>Lactates - pharmacology</subject><subject>Lactic Acid</subject><subject>Medical disorders</subject><subject>Medical sciences</subject><subject>Neuroses</subject><subject>Panic Disorder - etiology</subject><subject>Panic Disorder - physiopathology</subject><subject>Panic Disorder - therapy</subject><subject>Panic disorders</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Receptors, Cell Surface - drug effects</subject><subject>Receptors, Cell Surface - physiology</subject><subject>Relationship</subject><subject>Respiratory Center - drug effects</subject><subject>Respiratory Center - physiopathology</subject><subject>Respiratory system</subject><subject>Social research</subject><issn>0002-953X</issn><issn>1535-7228</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1993</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>K30</sourceid><sourceid>7QJ</sourceid><recordid>eNp1kctLAzEQxoMoWh9Xb0JR8aJb89wkRym-QPCi4C3MblJM2WbXZFvsf29Ki4joKUzmNzPfzIfQMcEjQmR5DdNuRAQeqRxyvYUGRDBRSErVNhpgjGmhBXvbQ_spTXOImaS7aFcxTakuB-h2DLFqw9D69tNbN3xfdi4mF5Lv_cL3y6v1z8KF3jfQ-zZcDSHYYQfB17kqtdG6eIh2JtAkd7R5D9Dr3e3L-KF4er5_HN88FcA56QtXEZoVMaVL5axg2vFKS1tqLLHQxJYYBBHUWlUBMOu4BZAlVpXlTjDL2QG6WPftYvsxd6k3M59q1zQQXDtPRkiZtyc6g6e_wGk7jyFrM5RirrSgJENn_0GEEVxSzqXM1GhN1bFNKbqJ6aKfQVwags3KApMtMNkCo8zKglxwsmk7r2bOfuObm-f8-SYPqYZmEiHUPn1jXFHF2Urd5RqDrvM_lP099AtK-JsA</recordid><startdate>19930801</startdate><enddate>19930801</enddate><creator>PAPP, L. A</creator><creator>KLEIN, D. F</creator><creator>GORMAN, J. 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Psychiatry</topic><topic>Receptors, Cell Surface - drug effects</topic><topic>Receptors, Cell Surface - physiology</topic><topic>Relationship</topic><topic>Respiratory Center - drug effects</topic><topic>Respiratory Center - physiopathology</topic><topic>Respiratory system</topic><topic>Social research</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>PAPP, L. A</creatorcontrib><creatorcontrib>KLEIN, D. F</creatorcontrib><creatorcontrib>GORMAN, J. 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A</au><au>KLEIN, D. F</au><au>GORMAN, J. M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Carbon dioxide hypersensitivity, hyperventilation, and panic disorder</atitle><jtitle>The American journal of psychiatry</jtitle><addtitle>Am J Psychiatry</addtitle><date>1993-08-01</date><risdate>1993</risdate><volume>150</volume><issue>8</issue><spage>1149</spage><epage>1157</epage><pages>1149-1157</pages><issn>0002-953X</issn><eissn>1535-7228</eissn><coden>AJPSAO</coden><abstract>OBJECTIVE: The purpose of this article is to offer a comprehensive,
data-based explanation of the relationship between hyperventilation and
panic disorder linking CO2 hypersensitivity, cognitive/behavioral factors,
and the respiratory effects of antipanic pharmacologic and psychological
treatments. METHOD: The authors conducted a computerized search of MEDLINE
for relevant articles. RESULTS: Some panic patients have a chronic, subtle
respiratory disturbance. Acute hyperventilation is neither necessary nor
sufficient for panic to occur. Respiratory abnormalities in panic patients
may adaptively aim at coping with a hypersensitive CO2 chemoreceptor
system. Pharmacologic panicogens also stimulate the respiratory system,
causing hyperventilation. Triggering this hypersensitive respiratory
control mechanism may incite panic. Antipanic medications may reset the
receptor threshold. Misattribution and catastrophic interpretation of
somatic symptoms or the sense of loss of control may contribute to panic
symptoms. Behavioral interventions such as desensitization or breathing
retraining may block the full-blown attack. Cognitive strategies through
cognitive control of respiration may supplement and accentuate these
interventions. CONCLUSIONS: Panic disorder may be due to an inherently
unstable autonomic nervous system, coupled with cognitive distress.</abstract><cop>Washington, DC</cop><pub>American Psychiatric Publishing</pub><pmid>8392296</pmid><doi>10.1176/ajp.150.8.1149</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-953X |
| ispartof | The American journal of psychiatry, 1993-08, Vol.150 (8), p.1149-1157 |
| issn | 0002-953X 1535-7228 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_57753519 |
| source | MEDLINE; Psychiatry Legacy Collection Online Journals 1844-1996; Periodicals Index Online; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Adult and adolescent clinical studies Alkalosis, Respiratory - chemically induced Alkalosis, Respiratory - complications Anxiety disorders. Neuroses Biological and medical sciences Carbon dioxide Carbon Dioxide - adverse effects Cognitive Therapy Humans Hyperventilation Hyperventilation - chemically induced Hyperventilation - complications Lactates - pharmacology Lactic Acid Medical disorders Medical sciences Neuroses Panic Disorder - etiology Panic Disorder - physiopathology Panic Disorder - therapy Panic disorders Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Receptors, Cell Surface - drug effects Receptors, Cell Surface - physiology Relationship Respiratory Center - drug effects Respiratory Center - physiopathology Respiratory system Social research |
| title | Carbon dioxide hypersensitivity, hyperventilation, and panic disorder |
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