The complex association of pulmonary function with panic disorder: a rejoinder to Ley (1998)

In a commentary on our paper entitled "Pulmonary function in panic disorder: evidence against the dyspnea-fear theory", Ley (1998) provides a critical analysis of our study. He concludes that our failed attempt to replicate a relationship between pulmonary function and the severity of panic-related symptoms in panic disorder patients may have been a consequence of a lack of comparability between studies, a statistical anomaly, and experimenter-demand effects. After discussing his comments (with most of them we do not agree) in depth, we maintain our conclusion that: (a) pulmonary impairment is not directly associated with panic symptoms; and (b) that the existence of a distinct subgroup of panic disorder patients with signs of actual airways obstruction leading to uncontrollable dyspnea and fear of suffocation remains questionable.