Carbon Dioxide Inhalation Induces Dose-Dependent and Age-Related Negative Affectivity

Griez, Eric; Colasanti, Alessandro; Diest, Rob van; Salamon, Ewa; Schruers, Koen

doi:10.1371/journal.pone.0000987

Cited by 72 publications

(66 citation statements)

References 38 publications

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“…Differently from Griez et al [41], who found older age associated with a decreased sensitivity to CO 2 in healthy volunteers, we were able to find only a mild, similar trend, possibly due to the narrower age range of our subjects.…”

Section: Discussioncontrasting

confidence: 99%

The Relationships between Adverse Events, Early Antecedents, and Carbon Dioxide Reactivity as an Intermediate Phenotype of Panic Disorder

Ogliari

Tambs

Harris

et al. 2009

Psychother Psychosom

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Background: Although adverse events have been consistently described to precede and potentially precipitate the onset of panic disorder, there is no information about their ability to alter the individual reactivity to inhaled carbon dioxide, a putative intermediate phenotype of susceptibility to panic disorder. Method: Seven-hundred twelve subjects belonging to the general population-based Norwegian Institute of Public Health Twin Panel underwent a 35% CO₂/65% O₂ inhalation challenge test and interview-based lifetime assessments of DSM-IV panic disorder, separation anxiety disorder, childhood parental separation/loss, major life events, adverse events of suffocative nature and common stressful life events. Regression models were applied to predict global subjective anxiety and DSM-IV panic symptoms after 35% CO₂/65% O₂ inhalation. Results: The responses to the challenge measured as semicontinuous variables were predicted by symptoms of childhood separation anxiety, childhood parental loss, common stressful events, major life events, suffocative events and the female gender. The role of most of these predictors was confirmed and held true after the exclusion of subjects with lifetime panic attacks/disorder from the analyses. Conclusions: Several factors which have been reported by previous clinical studies to influence the individual susceptibility to develop panic disorder seem to affect the individual reactivity to inhaled carbon dioxide in people from the general population. Some elements of risk may impact simultaneously upon the individual liability to panic and exaggerated sensitivity to hypercapnia.

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Section: Discussioncontrasting

confidence: 99%

The Relationships between Adverse Events, Early Antecedents, and Carbon Dioxide Reactivity as an Intermediate Phenotype of Panic Disorder

Ogliari

Tambs

Harris

et al. 2009

Psychother Psychosom

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“…Dizziness, sensation of shortness of breath, feeling of choking, and palpitations had the highest mean scores in all three CO 2 conditions (high, medium, and low). For both the eVAAS score and the PSL-IV total score, a statistically significant dose-response relationship was observed (these results are extensively presented elsewhere) (Griez et al, 2007). Each PSL symptom score was significantly dosedependent (po0.05).…”

Section: Resultsmentioning

confidence: 63%

“…We recently showed that increasing concentrations of CO 2 dose dependently induce a negative affect, which eventually culminates in genuine panic, also in healthy individuals (Griez et al, 2007). Accordingly, high doses of CO 2 may be considered as a model of panic in healthy subjects, just as moderate doses are in PD patients.…”

Section: Introductionmentioning

confidence: 99%

Carbon Dioxide-Induced Emotion and Respiratory Symptoms in Healthy Volunteers

Colasanti

Salamon

Schruers

et al. 2008

Neuropsychopharmacol

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A number of evidences have established that panic and respiration are closely related. Clinical studies indicated that respiratory sensations constitute a discrete cluster of panic symptoms and play a major role in the pathophysiology of panic. The aim of the present study was to explore the phenomenology of an experimental model of panic in healthy volunteers based on the hypothesis that: (1) we can isolate discrete clusters of panic symptoms, (2) respiratory symptoms represent a distinct cluster of panic symptoms, and (3) respiratory symptoms are the best predictor of the subjective feeling of panic, as defined in the DSM IV criteria.Sixty-four healthy volunteers received a double inhalation of four mixtures containing 0, 9, 17.5 and 35% CO 2, respectively, in a double-blind, cross-over, random design. An electronic visual analog scale and the Panic Symptom List (PSL) were used to assess subjective 'fear/discomfort' and panic symptoms, respectively. Statistical analyses consisted of Spearman's correlations, a principal component factor analysis of the 13 PSL symptoms, and linear regressions analyses.The factor analysis extracted three clusters of panic symptoms: respiratory, cognitive, and neurovegetative (r 2 ¼ 0.65). Respiratory symptoms were highly related to subjective feeling of fear/discomfort specifically in the CO 2 -enriched condition. Moreover, the respiratory component was the most important predictor of the subjective feeling of 'fear/discomfort' (b ¼ 0.54).The discrete clusters of symptoms observed in this study were similar to those elicited in panic attacks naturally occurring in patients affected by panic disorder. Consistent with the idea that respiration plays a crucial role in the pathophysiology of panic, we found that respiratory symptoms were the best predictors the subjective state defined in the DSM IV criteria for panic.

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“…A likely reason for the wide application of inhalation of CO 2 -enriched air is that it induces an increase in ventilation, escalating symptoms of arousal (Millhorn and Eldridge, 1986), and concomitant negative affect (Griez et al, 2007) in a dose-dependent way. In healthy volunteers, concentrations of 5 up to 7.5% CO 2 -enriched air for 2 min have been used to elicit mild transient physical symptoms such as increased ventilation, shortness of breath, feelings of warmth, sweating, and dizziness (Devriese et al, 2006;Stegen et al, 1998).…”

Section: Introductionmentioning

confidence: 99%