ASSOCIATION OF PANIC DISORDER WITH A HISTORY OF TRAUMATIC SUFFOCATION

Objective: An important recent hypothesis suggests that panic disorder results from a false suffocation alarm. However, the association of p anic disorder with a history of traumatic suffocation experiences (e.g ., near-drowning and near-choking) has not been well studied. This stu dy examined whether a history of traumatic suffocation might be more c ommon in patients with panic disorder who have predominantly respirato ry symptoms. Method: Patients with panic disorder (N=176) and psychiat ric comparison subjects (N=6) were questioned about a history of traum atic suffocation experiences. The panic disorder patients were classif ied as having predominantly respiratory, cardiovascular, occulovestibu lar, or gastrointestinal symptoms in order to determine a possible ass ociation between traumatic suffocation and symptom subtype. Results: T he frequency of traumatic suffocation was significantly higher among t he panic disorder patients (19.3%) than among the comparison subjects (6.7%). Within the panic disorder group, patients with a history of tr aumatic suffocation were significantly more likely to exhibit predomin antly respiratory symptoms and nocturnal panic attacks, while patients without such a history were significantly more likely to have predomi nantly cardiovascular symptoms, occulovestibular symptoms, and agoraph obia. Conclusions: There may be a specific association between panic d isorder and a history of traumatic suffocation, and such a history in turn appears associated with predominantly respiratory symptoms and no cturnal panic attacks. Although additional studies are needed to confi rm these data, a history of traumatic suffocation might be hypothesize d to play a role in the etiology of panic disorder in some patients an d may provide a useful window on understanding the psychobiology of th is disorder.