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Cited by 123Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesNeuroscience of respiration and sleepPsychosomatic Disorders and Their Treatments

Physiological Changes During Carbon Dioxide Inhalation in Patients With Panic Disorder, Major Depression, and Premenstrual Dysphoric Disorder: Evidence for a Central Fear Mechanism

Gorman, Jack M., Kent, Justine, Martinez, Jose, Browne, Susan, Coplan, Jeremy, Papp, Laszlo A.·2001·Archives of General Psychiatry
DOI 10.1001/archpsyc.58.2.125
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Abstract

Background Inhalation of carbon dioxide (CO(2)) has been shown to produce more anxiety in patients with panic disorder (PD) than in healthy comparison subjects or patients with most other psychiatric illnesses tested, although premenstrual dysphoric disorder (PMDD) may be an exception. Several reasons have been proposed to explain CO(2) breathing effects in PD. We examined differences in respiratory response to CO(2) breathing in 4 groups to address these issues. Methods Patients with PD (n = 52), healthy controls (n = 32), patients with PMDD (n = 10), and patients with major depression without panic (n = 21) were asked to breathe 5% and 7% CO(2). Continuous measures of respiratory physiological indices were made. Results Carbon dioxide breathing produced the expected increases in all 4 respiratory variables measured. More patients with PD and PMDD had panic attacks than did controls or patients with major depression. Subjects who experienced panic during 5% or 7% CO(2) inhalation had the most extreme increases regardless of diagnostic group. Among patients with PD, baseline end-tidal carbon dioxide levels were significantly lower in those who subsequently had a panic attack during 5% CO(2) breathing than those who did not. Conclusions Although CO(2) breathing causes a higher rate of panic attacks in patients with PD than other groups (except PMDD), the physiological features of a panic attack appear similar across groups. Once a panic attack is triggered, minute ventilation…

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  • Different emotional and cognitive states alter the depth and frequency of breathing, which impacts emotional state in part by regulation of carbon dioxide levels.

    “It is also clear that different emotional and cognitive states alter the depth and frequency of breathing,8,9,10,11,12 which likewise impacts emotional state, in part by regulation of carbon dioxide levels.13,14,15,16,17”

    From Brief structured respiration practices enhance mood and reduce physiological arousal (2023) · cites this paper as [15]

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Authors
Gorman, J. M., Kent, J., Martinez, J., Browne, S., Coplan, J., & Papp, L. A.
Affiliations
New York State Psychiatric Institute (US)
ORCID
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
2001-02-01
Volume
58
Issue
2
Pages
125
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archpsyc.58.2.125
OpenAlex
W2161078452
Cited by
123
References
7
Citations by year
2026: 2 · 2025: 3 · 2024: 3 · 2023: 6 · 2022: 3 · 2021: 1 · 2020: 6 · 2019: 5 · 2018: 4 · 2017: 3 · 2016: 4 · 2015: 3 · 2014: 5 · 2013: 7 · 2012: 6
FWCI
8.46
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01mh041778-08)
  • U.S. Public Health Service (NIH-00416)
  • Department of Psychiatry, Columbia University
  • National Institute of Mental Health (MH-41778, MH-30960)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
carbon dioxide inhalation, panic disorder, major depressive disorder, premenstrual dysphoric disorder, panic attacks, respiratory physiology, end-tidal carbon dioxide, minute ventilation, respiratory rate, anxiogenesis, fear conditioning
MeSH terms
Administration, Inhalation, Adult, Carbon Dioxide, Depressive Disorder, Female, Humans, Male, Premenstrual Syndrome, Respiratory Physiological Phenomena, Panic Disorder

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