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Related Experiment Videos

Hyperventilation and panic attacks in general hospital patients

P Spinhoven1, E J Onstein, P J Sterk

  • 1Department of Psychiatry, State University of Leiden, The Netherlands.

General Hospital Psychiatry
|May 1, 1993
PubMed
Summary

Panic attacks are common in general hospital patients with unexplained somatic symptoms, often mistaken for hyperventilation syndrome (HVS). Medical professionals should screen for panic disorder in these patients.

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Area of Science:

  • Psychiatry
  • Internal Medicine
  • Psychosomatic Medicine

Background:

  • Unexplained somatic symptoms in general hospitals are often associated with hyperventilation syndrome (HVS).
  • Panic attacks and panic disorder can manifest with physical symptoms, potentially overlapping with HVS presentations.

Purpose of the Study:

  • To determine the prevalence of panic attacks in patients presenting with somatic symptoms suggestive of HVS.
  • To compare the clinical characteristics and physiological responses of patients with and without panic attacks during a hyperventilation challenge.

Main Methods:

  • Assessed 2-week prevalence of panic attacks using DSM-III-R criteria in 102 general hospital patients with unexplained somatic symptoms.
  • Administered the Hyperventilation Provocation Test (HPT) and measured physiological parameters (base excess, respiratory volume, rate, end-tidal CO2).

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  • Compared self-reported symptom severity, anxiety, depression, and agoraphobic measures between panickers and non-panickers.

    • Main Results:

    • Thirty-six percent of patients were classified as panickers.
    • Panickers reported more severe panic, hyperventilation, and anxiety symptoms, alongside higher scores for depression and agoraphobia, compared to non-panickers.
    • No significant physiological differences (base excess, respiratory parameters) were found between panickers and non-panickers during the HPT.

    Conclusions:

    • Panic attacks have a high prevalence in general hospital patients with unexplained somatic symptoms suggestive of HVS.
    • Medical specialists need increased awareness to identify panic attacks or panic disorder in patients with somatic symptoms.
    • Distinguishing panic attacks from HVS requires careful clinical assessment beyond physiological measures.