A breath-holding challenge in panic disorder patients, their healthy first-degree relatives, and normal controls

Our aim was to observe the induction of panic attacks (PA) symptoms by a breath-hold test in panic disorder (PD) patients as the Diagnostic and Statistical Manual for Mental Disorders 4th edition (DSM-IV) and their healthy first-degree relatives. We randomly selected 26 PD patients, 28 healthy first-degree relatives of probands with PD and 25 normal volunteers with no family history of PD. They were induced to breath-hold for as long as possible four times with a two-min interval between them. Anxiety scales were applied before and after the test. Using specific PA criteria, 46.1% (n=12) PD patients, 7.1% (n=2) first-degree relatives and 4.0% (n=1) control subjects had a PA after the test (chi(2)=7.82, df=2, P=0.023). There was no heart rate, anxiety levels or breath-hold time differences among the groups. In this breath hold challenge test PD patients were more sensitive to breath-hold than first-degree relatives and normal volunteers.