Panic disorder and control of breathing
Abstract
Anxiety disorders, particularly panic disorder (PD), are associated with respiratory abnormalities. PD consists of unexpected panic attacks (PA) with anxiety, fear and many autonomic and respiratory symptoms. There is a substantial body of literature demonstrating that stimulation of respiration is a common event in panic disorder patients during PA. A number of abnormalities in respiration, such as enhanced CO(2) sensitivity, have been detected in PD patients. As a result, some investigators advanced that there is a fundamental abnormality in the physiological mechanisms that control breathing in PD. Studies indicate that PD patients with dominant respiratory symptoms are particularly sensitive to respiratory tests compared with those who do not manifest dominant respiratory symptoms, possibly representing a distinct subtype. Accumulated evidence suggests that respiratory physiology remains normal in PD patients and that their tendency to hyperventilate and to react with panic to respiratory stimulants like CO(2) represents the triggering of a hypersensitive fear network. However, some recent evidences support the presence of subclinical abnormalities in respiration and other functions related to body homeostasis. The fear network, composed by the hippocampus, the medial prefrontal cortex, the amygdala and its brainstem projections, may be abnormally sensitive in PD patients. This theory might explain why both medication and psychosocial therapies are clearly effective. The…
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Breathing engages in a reciprocal relationship with stress and anxiety, whereby stress and anxiety can both affect and be affected by altered respiratory patterns.
“Breathing also uniquely engages in a reciprocal relationship with stress and anxiety, whereby stress and anxiety can both affect [28,29,30,31,32,33] and be affected by [20,21,22,34] altered respiratory patterns.”
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- Authors
- Nardi, A. E., Freire, R. C., & Zin, W. A.
- Affiliations
- Universidade Federal do Rio de Janeiro (BR)
- Venue
- Respiratory Physiology & Neurobiology
- Publisher
- Elsevier BV
- Published
- 2009-05
- Volume
- 167
- Issue
- 1
- Pages
- 133-143
- ISSN
- 1569-9048 (ISSN-L)
- OpenAlex
- W2022045428
- Cited by
- 151
- References
- 6
- Citations by year
- 2026: 5 · 2025: 12 · 2024: 4 · 2023: 6 · 2022: 8 · 2021: 10 · 2020: 12 · 2019: 8 · 2018: 4 · 2017: 2 · 2016: 5 · 2015: 7 · 2014: 18 · 2013: 11 · 2012: 12
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Respiratory Physiology & Neurobiology (publishedVersion)
- PubMed (publishedVersion)
- 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
- panic disorder, panic attacks, respiratory control, hyperventilation, carbon dioxide sensitivity, respiratory hypersensitivity, fear network, amygdala, hippocampus, medial prefrontal cortex, anxiety disorders, respiratory symptoms
- MeSH terms
- Fear, Humans, Hyperventilation, Respiration, Panic Disorder
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