C. Bouwer et Dj. Stein, ASSOCIATION OF PANIC DISORDER WITH A HISTORY OF TRAUMATIC SUFFOCATION, The American journal of psychiatry, 154(11), 1997, pp. 1566-1570
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.