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Hyperventilation in Panic Attacks

Ambulant Monitoring of Transcutaneous Carbon Dioxide

Published online by Cambridge University Press:  02 January 2018

George Hibbert*
Affiliation:
Warneford Hospital, Oxford
David Pilsbury
Affiliation:
Warneford Hospital, Oxford
*
University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX

Abstract

Transcutaneous carbon dioxide monitoring has been used to investigate directly the frequency and role of hyperventilation during naturally occurring panic attacks in freely ambulant volunteers and patients. Illustrative preliminary data from healthy subjects and from four patients with panic attacks are presented. These confirm that some patients do hyperventilate during their attacks but indicate that some do not. The unreliability of traditional methods for identifying hyperventilators is demonstrated. These data indicate the potential of ambulant monitoring in research into hyperventilation and panic.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1988 

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References

Bass, C., Cawley, R., Wade, C., Ryan, K. C., Gardner, W. N. & Hutchison, D. C. S. (1983) Unexplained breathlessness and psychiatric morbidity in patients with normal and abnormal coronary arteries. The Lancet, i, 605609.CrossRefGoogle Scholar
Bass, C., & Gardner, W. N. (1985) Respiratory and psychiatric abnormalities in chronic symptomatic hyperventilation. British Medical Journal, 290, 13871390.Google Scholar
Bonn, J. A., Readhead, C. P. A. & Timmons, B. H. (1984) Enhanced adaptive behavioural response in agoraphobic patients pretreated with breathing retraining. The Lancet, ii, 665669.Google Scholar
Charney, D. S., Beninger, G. R. & Breier, A. (1984) Noradrenergic function in panic anxiety: effects of yohimbine in healthy subjects and patients with agoraphobia and panic disorder. Archives of General Psychiatry, 41, 751763.CrossRefGoogle ScholarPubMed
Charney, D. S., Beninger, G. R. & Jatlow, P. I. (1985) Increased anxiogenic effects of caffeine in panic disorders. Archives of General Psychiatry, 42, 233243.CrossRefGoogle ScholarPubMed
Clark, D. M. (1986) A cognitive approach to panic. Behaviour Research and Therapy, 24, 461470.Google Scholar
Clark, D. M., Salkovskis, P. M. & Chalkley, A. J. (1985) Respiratory control as a treatment for panic attacks. Journal of Behaviour Therapy and Experimental Psychiatry, 16, 2330.CrossRefGoogle ScholarPubMed
Compernolle, T., Hoogduin, K. & Joele, L. (1979) Diagnosis and treatment of the hyperventilation syndrome. Psychosomatics, 20, 612625.Google Scholar
Deal, E. C., McFadden, E. R., Ingram, R. H. & Jeager, J. J. (1979) Hyperpnoea and heat flux: initial reaction sequence in exercise induced asthma. Journal of Applied Physiology, 46, 476483.Google Scholar
Doorn, P., Folgeerine, H. & Colla, P. (1982) Control of end tidal PCO2 in the hyperventilation syndrome: effects of biofeedback and breathing instructions compared. Clinical Respiratory Physiology, 18, 829837.Google ScholarPubMed
Evans, D. W. & Lum, L. C. (1981) Hyperventilation as a cause of chest pain mimicking angina. Practical Cardiology, 7, 131139.Google Scholar
Fried, R., Rubin, S. R., Carlton, M. D. & Fox, M. C. (1984) Behavioural control of intractable idiopathic seizures: 1. Self regulation of end-tidal carbon dioxide. Psychosomatic Medicine, 46, 315331.Google Scholar
Kerr, W. J., Dalton, J. W. & Gliebe, P. A. (1937) Some physical phenomena associated with anxiety states and their relation to hyperventilation. Annals of Internal Medicine, 11, 961992.Google Scholar
Lewis, B. I. (1954) Chronic hyperventilation syndrome. Journal of the American Medical Association, 155, 12041208.Google Scholar
Lewis, R. A., Lewis, M. N. & Tattersfield, A. E. (1984) Psychological asthma and airway cooling. Clinical Respiratory Physiology, 20, 83.Google Scholar
Lubbers, D. W. (1979) Cutaneous and transcutaneous PO2 and PCO2 and their measuring conditions. Birth Defects, 15, 123.Google Scholar
Lum, L. C. (1976) The syndrome of habitual chronic hyperventilation. In Modern Trends in Psychosomatic Medicine, vol. 3 (ed. Hill, O. W.). London: Butterworth.Google Scholar
Lum, L. C. (1981) Hyperventilation and the anxiety state. Journal of the Royal Society of Medicine, 74, 14.Google Scholar
Lum, L. C. (1983) Physiological considerations in the treatment of hyperventilation syndromes. Journal of Drug Research, 8, 18671872.Google Scholar
Mattson, R. H., Heninger, G. R., Gallagher, B. B. & Glaser, G. H. (1970) Psychophysiologic precipitants of seizures in epileptics. Neurology, 20, 407.Google Scholar
Pilsbury, D. & Hibbert, G. (1987) An ambulatory system for long term continuous monitoring of transcutaneous PCO2 . Clinical Respiratory Physiology, 23, 913.Google ScholarPubMed
Pitts, F. N. & McClure, N. N. (1967) Lactate metabolism in anxiety neurosis. New England Journal of Medicine, 277, 13291336.Google Scholar
Salkovskis, P. M., Warwick, H. M. C., Clark, D. M. & Wessels, D. J. (1986) A demonstration of acute hyperventilation during naturally occurring panic attacks. Behaviour Research and Therapy, 24, 9194.Google Scholar
Severinghaus, J. W. (1982) Transcutaneous monitoring of arterial PCO2 . In Respiratory Monitoring in Intensive Care (ed. Spence, A. A.). Edinburgh: Churchill Livingstone.Google Scholar
Van den Hout, M. A. & Griez, E. (1984) Panic symptoms after inhalation of carbon dioxide. British Journal of Psychiatry, 144, 503507.CrossRefGoogle ScholarPubMed
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