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Panic Attacks and Perception of Inspiratory Resistive Loads in Chronic Obstructive Pulmonary Disease
Abstract
Rationale: Panic attacks are common in chronic obstructive pulmonary disease (COPD), and the prevalence of panic disorder is at least 10 times higher than in the general population. In the current study, we examined resistive load perception in patients with COPD with and without panic attacks. Objectives: We tested competing hypotheses, based on conflicting results of earlier studies, that those patients with COPD with panic attacks or panic disorder would show either heightened or blunted perception of dyspnea as the magnitude of inspiratory resistive loads increased. Methods: We compared 20 patients with COPD with panic attacks or panic disorder, 20 patients without panic, and 20 healthy, age-matched subjects using an inspiratory resistive load–testing protocol. Measurements and Main Results: We administered a diagnostic interview for panic attacks and panic disorder. We measured perceived dyspnea in response to increasing inspiratory resistive loads (modified Borg scale) and several respiratory variables. Dyspnea ratings increased linearly for all groups as the size of resistive loads increased. No significant differences were found between groups on the respiratory variables. Patients with COPD with panic attacks or panic disorder rated their level of dyspnea significantly higher than did other subjects. Conclusions: Patients with COPD with panic attacks showed heightened sensitivity to inspiratory loads. The result reinforces the influence of psychological factors on symptom perception in this disease.
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“It is well-recognised that the anxiety or fear caused by breathlessness can, in turn, augment the perception of breathlessness.”
From The Breathing, Thinking, Functioning clinical model: a proposal to facilitate evidence-based breathlessness management in chronic respiratory disease (2017) · cites this paper as [33]
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Metadata
- Authors
- Livermore, N., Butler, J. E., Sharpe, L., McBain, R. A., Gandevia, S. C., & McKenzie, D. K.
- Affiliations
- The University of Sydney (AU)
- UNSW Sydney (AU)
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-07-01
- Volume
- 178
- Issue
- 1
- Pages
- 7-12
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2170743337
- Cited by
- 113
- References
- 50
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 10 · 2023: 7 · 2022: 9 · 2021: 4 · 2020: 3 · 2019: 5 · 2018: 9 · 2017: 7 · 2016: 3 · 2015: 3 · 2014: 4 · 2013: 6 · 2012: 10
- FWCI
- 7.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Respiratory and Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
- Keywords
- panic attacks, panic disorder, chronic obstructive pulmonary disease, perceived dyspnea, dyspnea perception, Borg scale
- MeSH terms
- Aged, Aged, 80 and over, Anxiety, Inhalation, Dyspnea, Female, Forced Expiratory Volume, Humans, Male, Middle Aged, Perception, Vital Capacity, Work of Breathing, Panic Disorder, Pulmonary Disease, Chronic Obstructive
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