Clinical Characteristics of the Respiratory Subtype in Panic Disorder Patients

Abstract

ObjectivePanic disorder has been suggested to be divided into the respiratory and non-respiratory subtypes in terms of its clinical presentations. The present study aimed to investigate whether there are any differences in treatment response and clinical characteristics between the respiratory and non-respiratory subtypes of panic disorder patients.MethodsAmong the 48 patients those who completed the study, 25 panic disorder patients were classified as the respiratory subtype, whereas 23 panic disorder patients were classified as the non-respiratory subtype. All patients were treated with escitalopram or paroxetine for 12 weeks. We measured clinical and psychological characteristics before and after pharmacotherapy using the Panic Disorder Severity Scale (PDSS), Albany Panic and Phobic Questionnaire (APPQ), Anxiety Sensitivity Index-Revised (ASI-R), State-Trait Anxiety Inventory (STAI-T, STAI-S), Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Depression Rating Scale (HAM-D).ResultsThe prevalence of the agoraphobia was significantly higher in the respiratory group than the non-respiratory group although there were no differences in gender and medication between the two groups. The respiratory group showed higher scores on the fear of respiratory symptoms of the ASI-R. In addition, after pharmacotherapy, the respiratory group showed more improvement in panic symptoms than the non-respiratory group.ConclusionPanic disorder patients with the respiratory subtype showed more severe clinical presentations, but a greater treatment response to SSRIs than those with non-respiratory subtype. Thus, classification of panic disorder patients as respiratory and non-respiratory subtypes may be useful to predict clinical course and treatment response to SSRIs.

Panic disorder respiratory subtype: psychopathology and challenge tests – an update

“…Controversy remains regarding the expression of distinct clinical features between respiratory-related and nonrespiratory clusters. Freire et al 25 and Song et al 53 found a lower age of onset among RS compared to NRS patients (27.067.9 vs. 31.169.1 years, p = 0.016 and 35.4610.5 vs. 41.569.1 years, p = 0.04, in Freire et al 25 and Song et al, 53 respectively). However, no differences were observed in other studies.…”

“…7,[54][55][56] Biber & Alkin 54 found a longer duration of disease in the RS (50.8660.7 vs. 23.1623.5 months, p o 0.05), but this outcome was not found by others. 53,55 A family history of mental disorders was more prevalent in RS patients in several studies. 25,57,58 Demographic data, such as gender, age, occupation, education, and marital status, are consistently similar across the two groups.…”

“…However, Panic Disorder Severity Scale (PDSS) scores were similar in both subgroups. 53 Items of specific questionnaires, such as fear of suffocation and fear of other respiratory symptoms, are endorsed more often by patients in the RS than in other PD clusters. 52 RS exhibited higher agoraphobic and panic-like symptoms and increases in Anxiety Sensitivity Index scores than NRS patients, but there was no subtype distinction based on severity scales (PDSS and Panic and Agoraphobia Scale [PAS]).…”

Avaliação do efeito em longo prazo do estresse neonatal causado pela separação ou privação materna em ratos sobre a expressão de comportamentos defensivos associados ao pânico

“…This subdivision between respiratory and non-respiratory panic was proposed based on the observation of different symptomatic profile presented during a panic attack in which some patients respond with prominent respiratory symptoms while others do not (Briggs et al, 1993). Since then, several studies have been corroborating this subdivision (Song et al, 2014;Zugliani et al, 2015;Roberson-Nay e Kendler, 2011;Roberson-Nay et al, 2012;Valenca et al, 2002).…”

“…LAJUD, et al, 2012;ROMAN, et al, ZHANG, et al, 2012). (AISA, et al, 2007;MARTISOVA, et al, 2012SOLAS, et al, 2010 Trabalhos mais recentes têm correlacionado os ataques de pânico respiratórios com uma forma mais severa do transtorno de pânico (SONG et al, 2014;ROBERSON-NAY, LATENDRESSE e KENDLER, 2012;VALENCA et al, 2012).…”