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Cited by 254Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesNeuroscience of respiration and sleepPsychosomatic Disorders and Their Treatments

Respiratory psychophysiology of panic disorder: three respiratory challenges in 98 subjects

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Papp, Laszlo A., Martinez, Jose M., Klein, Donald F., Coplan, Jeremy D., Norman, Robert G., Cole, Randolph, de Jesus, Marybeth J., Ross, Donald +2 more·1997·American Journal of Psychiatry
DOI 10.1176/ajp.154.11.1557
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Abstract

Objective Respiratory abnormalities may play a central role in the pathophysiology of panic disorder. The current study was undertaken to examine the respiratory response in the largest series of subjects to date during three respiratory challenges that used improved methodology. Method Fifty-nine patients with DSM-III-R panic disorder and 39 normal volunteers were challenged with 5% and 7% CO2 inhalation and room air hyperventilation separated by room air breathing with continuous spirometry. Results Patients with panic disorder were more sensitive to the anxiogenic effects of CO2 than were normal subjects, and CO2 was a more potent stimulus to panic than hyperventilation. Patients increased their respiratory rate more quickly during CO2 inhalation than did comparison subjects, and this increase preceded the panic attacks. Patients who panicked in response to 5% CO2 demonstrated continued rise in end-tidal CO2, while the end-tidal CO2 of the comparison groups stabilized. Low end-tidal CO2 and high variance in minute ventilation at baseline predicted panic attacks during CO2 inhalation. Following CO2 or hyperventilation challenges, respiratory rate dropped sharply, while tidal volume remained elevated longer in patients than in comparison subjects. Conclusions The findings confirm the greater behavioral and physiological sensitivity of patients with panic disorder to CO2 inhalation and identify a series of respiratory abnormalities. Panic attacks in panic disorder may be expl…

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Crossref · 10.1176/ajp.154.11.1557

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  • Studies of baseline pCO2 in panic disorder patients are mixed, with some showing lower levels than healthy controls and others showing no differences.

    “Regarding baseline levels of pCO2 studies are more mixed, with some showing lower levels in PD patients than healthy controls during baseline periods (Papp et al., 1997; Wilhelm et al., 2001; Hegel and Ferguson, 1997) and others no differences in comparison to control or other anxious groups (e.g. Holt and Andrews, 1998; Woods et al., 1986).”

    From Feedback of end-tidal pCO2 as a therapeutic approach for panic disorder (2008) · cites this paper as Papp et al., 1997

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Authors
Papp, L. A., Martinez, J. M., Klein, D. F., Coplan, J. D., Norman, R. G., Cole, R., de Jesus, M. J., Ross, D., Goetz, R., & Gorman, J. M.
Affiliations
New York State Psychiatric Institute (US)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
1997-11-01
Volume
154
Issue
11
Pages
1557-1565
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/ajp.154.11.1557
OpenAlex
W1841707297
Cited by
254
References
6
Citations by year
2026: 6 · 2025: 1 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 5 · 2020: 3 · 2019: 7 · 2018: 8 · 2017: 2 · 2016: 2 · 2015: 6 · 2014: 8 · 2013: 6 · 2012: 6
FWCI
11.28
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • American Journal of Psychiatry (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01mh041778-08, 5k20mh000858-02)
  • National Institute of Mental Health (MH-41778, MH30906, MH 00858)
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, hypercapnia, hyperventilation, end-tidal carbon dioxide, respiratory rate, tidal volume, minute ventilation, panic attacks
MeSH terms
Administration, Inhalation, Adult, Carbon Dioxide, Female, Humans, Hyperventilation, Male, Middle Aged, Respiration, Respiration Disorders, Tidal Volume, Panic Disorder

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