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The 35% CO2 inhalation procedure: test-retest reliability.

W Coryell¹, S Arndt

¹Department of Psychiatry, University of Iowa, Iowa City, USA.

Biological Psychiatry

|April 15, 1999

Summary

The 35% carbon dioxide (CO2) challenge test shows potential for studying panic disorder. However, more research is needed to understand test result variability before clinical use.

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Area of Science:

Psychiatry
Psychology
Neuroscience

Background:

The 35% carbon dioxide (CO2) challenge test is a promising tool for panic disorder research.
Its reliability as a trait marker for panic disorder requires further investigation.

Purpose of the Study:

To assess the reliability of the 35% CO2 challenge test in individuals at high risk for panic disorder.
To compare test results between high-risk individuals and control groups.

Main Methods:

Subjects inhaled a single breath of 35% CO2 and rated anxiety symptoms immediately after.
The procedure was repeated after a mean interval of 29 days.
High-risk group: first-degree relatives of panic disorder patients. Control groups: relatives of affective disorder patients and individuals with no family history of panic or affective disorders.

Main Results:

High-risk individuals consistently reported higher symptom scores than controls on both test occasions.
"Smothering sensations" ratings showed high correlation across tests and effectively distinguished between groups.
Optimal symptom thresholds for defining panic attacks varied between testing occasions, with a lower threshold being more effective on retesting.

Conclusions:

The 35% CO2 challenge test demonstrates potential as a reliable indicator for panic disorder, particularly with specific symptom ratings like "smothering sensations."
Variability in test results necessitates further research into optimal thresholds and influencing factors before widespread clinical application.
A single positive test result may be more informative than a single negative result.

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