Hostname: page-component-8448b6f56d-wq2xx Total loading time: 0 Render date: 2024-04-19T05:05:01.401Z Has data issue: false hasContentIssue false

Symptom Specificity in Patients with Panic

Published online by Cambridge University Press:  02 January 2018

Paul Lelliott
Affiliation:
Greenwich District Hospital, Vanbrugh Hill, London SEW 9HE
Christopher Bass*
Affiliation:
Academic Department of Psychological Medicine, King's College Hospital, Denmark Hill, London SE5 9RS
*
Correspondence

Abstract

Thirteen patients with panic disorder with predominantly cardiorespiratory (CR) symptoms were compared with seven patients with predominantly gastrointestinal (Gl) symptoms in an experimental procedure that involved exposure to phobia talk and voluntary hyperventilation (VHV). The CR patients had not only higher baseline anxiety, but also during phobia talk had a greater fall in pCO2 and reported more respiratory symptoms than the Gl patients. Moreover, the CR group found VHV more unpleasant and more like their panic attacks than the Gl panickers, and reported more physical symptoms after it. These findings suggest that patients with PD are not only heterogeneous with respect to the system to which panic symptoms refer (CR or Gl) but that provoking arousal in one system is more likely to produce distress if that system is the major focus of complaint. These findings, if replicated, would not support the suggestion that panic disorder is a uniform illness.

Type
Papers
Copyright
Copyright © Royal College of Psychiatrists, 1990 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Bass, C., Kartsounis, L. & Lelliott, P. (1987) Hyperventilation and its relation to anxiety and panic. Integrative Psychiatry, 5, 274291.Google Scholar
Bass, C., Lelliott, P. & Marks, I. M. (1989) Fear talk versus voluntary hyperventilation in agoraphobics and normals: a controlled study. Psychological Medicine, 19, 669676.Google Scholar
Clark, D. M. & Hemsley, D. R. (1982) The effects of hyperventilation; individual variability and its relation to personality. Journal of Behaviour Therapy and Experimental Psychiatry, 13, 4147.Google Scholar
Derogatis, L. R., Lipman, R. S. & Covi, L. (1973) The SCL-90: an out-patient psychiatric rating scale. Psychopharmacology Bulletin, 9, 1328.Google Scholar
Grossman, P. & DeSwart, J. C. G. (1984) Diagnosis of hyperventilation on the basis of reported complaints. Journal of Psychosomatic Research, 28, 97104.CrossRefGoogle ScholarPubMed
Hibbert, G. A. (1984) Hyperventilation as a cause of panic attacks. British Medical Journal, i, 263264.Google Scholar
Klerman, G. (1986) Current trends in clinical research on panic attacks, agoraphobia, and related anxiety disorders. Journal of Clinical Psychiatry, 47 (suppl. 6), 3739.Google Scholar
Lacey, J. I., Bateman, D. E. & Van Lehn, R. (1953) Autonomic response specificity. Psychosomatic Medicine, 15, 821.Google Scholar
Lang, P. J. (1979) A bio-informational theory of emotional imagery. Psychophysiology, 16, 495512.Google Scholar
Lydiard, R. B., Laraia, M. T., Howell, E. F., et al (1986) Can panic disorder present as irritable bowel syndrome? Journal of Clinical Psychiatry, 47, 470472.Google ScholarPubMed
Malmo, R. & Shagass, C. (1949) Physiologic study of symptom mechanisms in psychiatric patients under stress. Psychosomatic Medicine, 11, 2529.Google Scholar
Margraf, J., Ehlers, A. & Roth, W. T. (1986) Biological models of panic disorder and agoraphobia – a review. Behaviour Research and Therapy, 24, 553567.Google Scholar
Marks, I. M. & Matthews, A. M. (1979) Brief standard self-rating for phobic patients. Behaviour Research and Therapy, 17, 263267.Google Scholar
Rapee, R. (1986) Differential response to hyperventilation in panic disorder and generalised anxiety disorder. Journal of Abnormal Psychology, 95, 2428.CrossRefGoogle Scholar
Sheehan, D. V. & Sheehan, K. H. (1983) The classification of phobic disorders. International Journal of Psychiatric Medicine, 12, 243266.Google Scholar
Spitzer, R. L. & Williams, J. B. W. (1983) Structured Clinical Interview for the DSM–III (SCID). New York: New York State Psychiatric Institute.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.