Trauma and trauma-related symptomatology in patients with respiratory subtype of panic disorder

Objective: Panic disorder (PD) is severe anxiety disorder characterized by sudden attacks of immediate physical discomfort and losing control or fear of dying. Due to differences in drug response, and in order to show the dispersion of somatic symptom, the subtyping studies were performed. Respiratory subtypes is one of the deemed worthy to investigate. PD has been linked to respiratory abnormalities such as chronic hyperventilation associated with hypocapnia related to hypersensitive respiratory control system. Disordered breathing plays very important role in the pathophysiology of PD. The studies indicated that PD patients have greater respiratory disorders than controls. Evidence of higher variability and irregularity in respiratory patterns of PD patients was found but it could not explain the reason of respiratory abnormalities in PD. It is frequently and mutually reported that trauma and dissociative symptomatology were associated with PD. Trauma and its modification, which has been associated with PD and dissociative symptoms due to emotional processing of the information related to the trauma. Such a strategy existence of dissociation suggests to avoid trauma related aversive emotions/memories. The aim of this study was to investigate the presence of trauma history and clinical features of the respiratory subtype of panic disorder (PD) versus the non-respiratory subtype.

Method: The participants diagnosed as panic disorder according to DSM-IV diagnostic criteria, who applied to Policlinic of Psychiatry of Erenkoy Mental and Neurological Disease Training and Research Hospital, were divided into two subtypes according to the respiratory dimension. The Patient Health Questionnaire Somatization/ Anxiety/ Depression (PHQ-SADS), the Traumatic Experiences Checklist (TEC), and the Dissociative Experience Scale (DES) were used.

Results: Somatization, anxiety, depression, and dissociation in the respiratory subtype had not a significantly higher than those in the non-respiratory subtype. Traumatic experiences were shown to be different in patients with PD, although this difference was not statistically significant.

Conclusion: Childhood maltreatment and subsequent psychiatric manifestations in panic disorder with or without respiratory were not seen that the differentiation. To demonstrate these differences studies should be conducted with a large sample and different clinical populations. In addition, there is a need for research on genetic inşuences on PD.