ANXIETY AND CONGENITAL CENTRAL HYPOVENTILATION SYNDROME

Objective: It has been hypothesized that individuals who cannot percei ve elevations of CO2 will be less anxious than individuals with intact CO2 perception. To test this hypothesis, children with congenital cen tral hypoventilation syndrome, who have a potentially lethal chronic i llness associated with lack of CO2 perception and thus provide a natur al experimental group, were studied. Method: Rates of anxiety symptoms and disorders in children with congenital central hypoventilation syn drome (N=13) were compared with rates in an age-matched, nonreferred g roup of community subjects (N=292) that included subgroups of children with asthma (N=15) and other chronic medical illnesses (N=66). Anxiet y symptoms were assessed with information obtained from structured int erviews of the parents, which provided both total symptom scores and D SM-III-R diagnoses. Results: The children with congenital central hypo ventilation syndrome exhibited significantly fewer anxiety symptoms th an all other comparison subjects. Two of these children (15%) met crit eria for anxiety disorders, a rate lower than that of the whole commun ity group (24%) and of the chronically ill comparison subgroups (32%-4 7%). The largest difference in the prevalence of disorder emerged betw een the children with congenital central hypoventilation syndrome (15% ) and those with asthma (47%). In the comparison of children with cong enital central hypoventilation syndrome and children with other chroni c illnesses, a priori analysis showed that the former had significantl y lower rates of disorders that have been linked to panic in the liter ature. Conclusions: This study supports theories of anxiety that impli cate CO2 perception in the pathophysiology of panic and related anxiet y states.