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[Immediate and secondary prognosis of suffocation fits from post-tuberculous respiratory insufficiencies (author's transl)].

Prognosis for an immediate future and up to one year of decompensation periods was comparable both in chronic bronchitic patients and in ancient tuberculous ones. The latter can be divided in two groups, "amputated" and "non-amputated", according to the main kind of sequellae, pleural and/or parenchymatous. The immediate future is identical and then, the prognosis of the "amputated" which was rather more favourable at one year progressively worsens to reach that of "non-amputated" patients.

Adult↗
PubMed1993

Selves that starve and suffocate: the continuum of eating disorders and dissociative phenomena.

Recent reports suggest a link between eating disorders and dissociative phenomena. The author offers a psychodynamic perspective on this connection and proposes that these disorders may occur along a continuum. Viewing these conditions as related suggests that eating disorders, like dissociative disorders, may have not only self-destructive but also self-preserving aspects. The author explores treatment implications of this perspective.

Dissociative Disorders↗
PubMed2006

Component fears of claustrophobia associated with mock magnetic resonance imaging.

A conceptualization of claustrophobia [Rachman, S., & Taylor, S. (1993). Analyses of claustrophobia. Journal of Anxiety Disorders, 7, 281-291] was evaluated in the context of magnetic resonance imaging. One hundred eleven students responded to questionnaires that quantified fear of suffocation, fear of restriction, and sensitivity to anxiety symptoms. Sixty-four of them were then exposed to a mock magnetic resonance imaging assessment; maximum subjective fear during the mock assessment was self-reported, behavioral reactions to the mock assessment were characterized, and heart rates before and during the assessment were recorded. Scores for fear of suffocation, fear of restriction, and anxiety sensitivity were used to predict subjective, behavioral, and cardiac fear. Subjective fear during the mock assessment was predicted by fears of suffocation and public anxiousness. Behavioral fear (escape/avoidance) was predicted by fears of restriction and suffocation, and sensitivity to symptoms related to suffocation. Cardiac fear was predicted by fear of public anxiousness. The criterion variance predicted was impressive, clearly sufficient to legitimize both the research preparation and the conceptualization of claustrophobia that was evaluated.

Adult↗
PubMed1997

Panic disorder with smothering symptoms: evidence for increased risk in first-degree relatives.

Klein's (1993: Arch Gen Psychiatry 50:306-317) "false suffocation alarm" theory of spontaneous panic attacks posits that central receptors compare CO2, O2, and lactate levels and trigger panic when an impending "false" state of suffocation is detected. Several investigators have found abnormalities of respiratory physiology in subjects with panic disorder. Twin and family studies have suggested that both panic disorder and tidal volume response to CO2 are inherited. We hypothesized that, if smothering symptoms are a marker for a hypersensitive suffocation detector and if this hypersensitivity is familial, then relatives of panic subjects with smothering symptoms would have higher rates of panic with smothering than relatives of panic subjects without smothering. We conducted a family study involving 104 panic disorder probands and 247 of their interviewed first-degree relatives. Probands and their relatives were interviewed using the Schedule for Affective Disorders and Schizophrenia--Lifetime Version for Anxiety Disorders to determine their panic disorder and smothering symptom status. Relatives of panic probands with smothering symptoms had an almost threefold higher risk for panic and an almost sixfold higher risk for panic with smothering symptoms when compared with relatives of panic probands without smothering. We conclude that panic disorder with smothering symptoms may be a subtype of panic disorder associated with increased familial risk and may be a group of interest to genetic investigators. These findings provide the first empiric evidence from a family study in support of Klein's false suffocation alarm theory of spontaneous panics.

Adult↗
PubMed2002

Effects of tryptophan depletion on central and peripheral chemoreflexes in man.

Klein (Arch. Gen. Psychiatry 50, 306-317, 1993) suggests that panic attacks are the result of a defective 'suffocation alarm' threshold that presents with carbon dioxide (CO(2)) hypersensitivity, exaggerated ventilatory response and panic in panic disorder (PD) patients. Serotonergic deficiencies enhance this ventilatory response in PD patients, as per 'suffocation alarm' theory predictions, suggesting that serotonin (5-HT) normalizes the ventilatory response. Other research supports a serotonin system-mediated stimulation of ventilation. Knowledge of 5-HT's role on ventilatory output and its neurophysiological sources impacts on the 'suffocation alarm' theory validity and predictive value. We used tryptophan depletion (TRP-) in concert with a modified Read rebreathing test to determine the effect of deficient serotonergic modulation on the central and peripheral chemoreflex threshold and sensitivity of response to CO(2) in 11 healthy men. TRP- did not affect central or peripheral chemoreflex threshold or sensitivity of response to CO(2). However, basal ventilation was significantly elevated during TRP-. In contrast to 'suffocation alarm' theory predictions, decreased 5-HT neurotransmission does not significantly affect the respiratory chemoreflex response to CO(2), impacting on non-chemoreflex drives to breathe. Panic associated respiratory abnormalities may be related to defective 5-HT modulation of non-chemoreflex drives to breathe, unrelated to any respiratory chemoreflex abnormality.

Adult↗