Panic Disorder Respiratory Subtype: Psychopathology, Laboratory Challenge Tests, and Response to Treatment

Abstract

Some characteristics, such as the increased sensitivity to CO(2) and the higher familial history of PD, clearly distinguish the RS from the non-RS. Nevertheless, there are also controversial findings. More studies are needed to determine the validity of the RS subtype.

Are patients with panic disorder respiratory subtype more vulnerable to tobacco, alcohol or illicit drug use?

“…There were also conflicting findings regarding the duration of the illness 5,10 . High prevalence of respiratory symptoms was found in patients with nocturnal PAs or traumatic suffocation history 3 .…”

“…As a response to these concerns, alternative classification schemes have been devised 2 . Several studies indicated that PD patients with prominent respiratory symptoms may represent a distinct subtype of this disorder 3 . High rates of alcohol 4 and cigarette 5 use have been found in respiratory subtype patients.…”

“…There is scientific evidence that the "respiratory symptoms" group is a distinct PD subtype 3,8 . Briggs et al 8 studied the descriptions of the most recent severe panic attack of 1108 PD patients and performed a principal component analysis of the symptoms.…”

“…Recent studies indicate that respiratory subtype patients may have higher familial history of PD, lower neuroticism scores, and higher scores in severity scales compared to non-respiratory subtype patients 3,9 . Roberson-Nay et al 10 studied the PD respiratory subtype in an epidemiologic sample (n = 2294) and a clinical sample (n = 1169) and found high temporal stability for the subtype.…”

“…Through this pathway, PD would increase the risk of smoking; (e) the co-ocurrance of smoking and PD suggest the two problems may share a common vulnerability such as neuroticism or other personality features 15 . Respiratory abnormalities are present in both smokers and PD patients 16 , and they are more frequent in the respiratory subtype 3 suggesting there may be an association between smoking and the respiratory subtype. Biber and Alkin 5 found a higher proportion of smokers and higher cigarette consumption in the respiratory subtype patients compared to the non-respiratory subtype.…”