High altitudes, anxiety, and panic attacks: Is there a relationship?

Depression and Anxiety

Volumn 16, Issue 2, 2002, Pages 51-58

  Roth, Walton T ^a,b   Gomolla, Annette ^a,b,c   Meuret, Alicia E ^a,b   Alpers, Georg W ^a,b,d   Handke, Eva M ^a,b   Wilhelm, Frank H ^a,b  

^a STANFORD UNIVERSITY   (United States)

^b VA PALO ALTO HEALTH CARE SYSTEM   (United States)

^c UNIVERSITY OF KONSTANZ   (Germany)

^d UNIVERSITY OF WÜRZBURG   (Germany)

Author keywords

Altitude sickness; Anxiety; High altitude; Hyperventilation; Hypocapnia; Hypoxia; Panic disorder; PCO2; Review

Indexed keywords

ADAPTATION; ALTITUDE; ALTITUDE DISEASE; ANXIETY; DISEASE PREDISPOSITION; DYSPNEA; HEADACHE; HEART PALPITATION; HUMAN; HYPERVENTILATION; HYPOCAPNIA; HYPOXIA; INSOMNIA; PANIC; PRIORITY JOURNAL; PSYCHOSOMATIC DISORDER; RESPIRATORY DISTRESS; REVIEW; SLEEP; VERTIGO;

ADAPTATION, PHYSIOLOGICAL; ALTITUDE SICKNESS; ANOXIA; ANXIETY; HUMANS; HYPOCAPNIA; PANIC DISORDER;

EID: 0036380143     PISSN: 10914269     EISSN: None     Source Type: Journal    
DOI: 10.1002/da.10059     Document Type: Review

References (56)

1. American Psychiatric Association. 1994. Diagnostic and statistical manual of mental disorders, 4th edition. Washington, DC: American Psychiatric Association.
2. Barlow DH, Craske MG, Cerny JA, Klosko JS. 1989. Behavioral treatment of panic disorder. Behavior Ther 20:261-282.
3. 2 in panic disorder: a comparison of hypercapnic and hypoxic challenges. J Abnorm Psychol 108:473-482.
4. Bender PR, Weil JV, Reeves JT, Moore LG. 1987. Breathing pattern in hypoxic exposures of varying duration. J Appl Physiol 62: 640-645.
5. Bolmont B, Thullier F, Abraini JH. 2000. Relationships between mood states and performances in reaction time, psychomotor ability, and mental efficiency during a 31-day gradual decompression in a hypobaric chamber from sea level to 8848 m equivalent altitude. Physiol Behav 71:469-476.
6. Bouton ME, Mineka S, Barlow DH. 2001. A modern learning theory perspective on the etiology of panic disorder. Psychol Rev 108:4-32.
7. Clark DM. 1986. A cognitive approach to panic. Behav Res Ther 24:461-470.
8. Clark DM, Salkovskis PM, Chalkley AJ. 1985. Respiratory control as a treatment for panic attacks. J Behav Ther Exp Psychiatry 16:23-30.
9. Clark DM, Salkovskis PM, Hackmann A, Wells A, Ludgate J, Gelder M. 1999. Brief cognitive therapy for panic disorder: a randomized controlled trial. J Consult Clin Psychol 67:583-589.
10. Derogatis LR. 1977. SCL-90 Administration, scoring, and procedures manual-I for the revised version. Baltimore: Johns Hopkins University School of Medicine.
11. Dillon DJ, Gorman JM, Liebowitz MR, Fyer AJ, Klein DF 1987. Measurement of lactate-induced panic and anxiety. Psychiatry Res 20:97-105.
12. Fitzgerald RS, Lahiri S. 1986. Reflex responses to chemoreceptor stimulation. Handbook of physiology. II. The respiratory system. Bethesda: American Physiological Society. p 313-351.
13. Garssen B, Buikhuisen M, van Dyck R. 1996. Hyperventilation and panic attacks. Am J Psychiatry 153:513-518.
14. Gendreau MA, DeJohn C. 2002. Responding to medical events during commercial airline flights. N Engl J Med 346:1067-1073.
15. Grover RF, Weil JV, Reeves JT 1986. Cardiovascular adaptation to exercise at high altitude. Exerc Sport Sci Rev 14:269-302.
16. Guyton AC, Hall JE. 1996. Textbook of medical physiology, 9th ed. Philedelphia: WB Saunders.
17. Hibbert G, Pilsbury D. 1989. Hyperventilation: is it a cause of panic attacks. Br J Psychiatry 155:805-809.
18. Hibbert GA, Pilsbury D. 1988. Hyperventilation in panic attacks: ambulant monitoring of transcutaneous carbon dioxide. Br J Psychiatry 153:76-80.
19. Honigman B, Read M, Lezotte D, Roach R. 1995. Sea-level physical activity and acute mountain sickness at moderate altitude. West J Med 163:117-121.
20. Kenardy J, Oei TP, Evans L. 1990. Hyperventilation and panic attacks. Aust N Z J Psychiatry 24:261-267.
21. Kerr WJ, Dalton JW, Gliebe PA. 1937. Some physical phenomena associated with anxiety states and their relationship to hyperventilation. Ann Intern Med 11:961-992.
22. Klein DF. 1993. False suffocation alarms, spontaneous panics, and related conditions. An integrative hypothesis [see comments]. Arch Gen Psychiatry 50:306-317.
23. Lahiri S, Maret K, Sherpa M. 1983. Dependence of high altitude sleep apnea on ventilatory sensitivity to hypoxia. Respir Physiol 52:281-301.
24. Ley R. 1985. Agoraphobia, the panic attack and the hyperventilation syndrome. Behav Res Ther 23:79-81.
25. 2. Jpn J Physiol 39:523-535.
26. Meuret AE, Wilhelm FH, Roth WT. 2001. Respiratory biofeedback assisted therapy for panic disorder. Behav Modif 25:584-605.
27. Missoum G, Rosnet E, Richalet J. 1992. Control of anxiety and acute mountain sickness in Himalayan mountaineers. Int J Sports Med 13:S37-S39.
28. Moran C. 1986. Depersonalization and agoraphobia associated with marijuana use. Br J Med Psychol 59:187-196.
29. Morgan WP. 1995. Anxiety and panic in recreational scuba divers. Sports Med 20:398-421.
30. Nelson M. 1982. Psychological testing at high altitudes. Aviat Space Environ Med 53:122-126.
31. Nicolas M, Thullier-Lestienne F, Bouquet C, et al. 1999. An anxiety, personality and altitude symptomatology study during a 31-day period of hypoxia in a hypobaric chamber (experiment 'Everest-Comex 1997'). J Environ Psychol 19:407-414.
32. Papp LA. 1995. Respiratory neurobiology of panic. In: Asnis GM, Van Praag HM, editors. Panic disorder: clinical, biological and treatment aspects. New York: John Wiley and Sons. p 255-275.
33. Papp LA, Martinez JM, Klein DF, et al. 1997. Respiratory psychophysiology of panic disorder: three respiratory challenges in 98 subjects. Am J Psychiatry 154:1557-1565.
34. Papp LA, Welkowitz LA, Martinez JM, Klein DF, Browne S, Gorman JM. 1995. Instructional set does not alter outcome of respiratory challenges in panic disorder. Biol Psychiatry 38: 826-830.
35. Porcelli MJ, Gugelchuk GM. 1995. A trek to the top: a review of acute mountain sickness. J Am Osteopath Assoc 95:718-720.
36. Rapee R, Mattick R, Murrell E. 1986. Cognitive mediation in the affective component of spontaneous panic attacks. J Behav Ther Exp Psychiatry 17:245-253.
37. Reiss S, Peterson RA, Gursky DM, McNally RJ. 1986. Anxiety sensitivity, anxiety frequency, and the prediction of fearfulness. Behaviour Res Ther 24:1-8.
38. Roach RC, Greene ER, Schoene RB, Hackett PH. 1998. Arterial oxygen saturation for prediction of acute mountain sickness. Aviat Space Environ Med 69:1182-1185.
39. Roy-Byrne PP, Uhde TW. 1988. Exogenous factors in panic disorder: clinical and research implications. J Clin Psychiatry 49:56-61.
40. Salkovskis PM, Clark DM. 1990. Affective responses to hyperventilation: a test of the cognitive model of panic. Behav Res Ther 28:51-61.
41. Santolaya RB, Lahiri S, Alfaro RT, Schoene RB. 1989. Respiratory adaptation in the highest inhabitants and highest Sherpa mountaineers. Respir Physiol 77:253-262.
42. Shukitt-Hale B, Banderet LE, Lieberman HR. 1991. Relationships between symptoms, moods, performance, and acute mountain sickness at 4,700 meters. Aviat Space Environ Med 62:865-869.
43. Smoller JW, Pollack MH, Otto MW, Rosenbaum JF, Kradin RL. 1996. Panic anxiety, dyspnea, and respiratory disease: theoretical and clinical considerations. Am J Respir Crit Care Med 154:6-17.
44. Spielberger CD, Gorsuch RL, Luchene RE. 1970. State-trait anxiety inventory. Palo Alto: Consulting Psychology Press.
45. Stamper D, Sterner R, Kinsman R. 1971. Symptomatology subscales for the measurement of acute mountain sickness. Percept Mot Skills 33:735-742.
46. Stein J, Papp L, Klein D, et al. 1992. Exercise tolerance in panic disorder patients. Biol Psychiatry 32:281-287.
47. Stein MB, Millar TW, Larsen DK, Kryger MH. 1995. Irregular breathing during sleep in patients with panic disorder. Am J Psychiatry 152:1168-1173.
48. Tochimoto S, Kitamura T, Kurata K, Nakamura I, Koshino Y. 1998. 'Chiyamai', a panic-like disorder in woman divers from Hegura Island. Psychiatry Clin Neurosci 52:425-427.
49. Uhde TW. 2000. Anxiety disorders. In: Kryger MH, Roth T, Dement WC, editors. Principles and practice of sleep medicine, 3rd ed. Philadelphia: WB Saunders Company. p 1123-1139.
50. 2, respiratory pattern variability, and transfer function RSA. In: Fahrenberg J, editor. Progress in ambulatory assessment. Göttingen: Hogrefe and Huber. p 313-343.
51. Wilhelm FH, Gerlach AL, Roth WT. 2001b. Slow recovery from voluntary hyperventilation in panic disorder. Psychosom Med 63:638-649.
52. Wilhelm FH, Gevirtz R, Roth WT. 2001c. Respiratory dysregulation in anxiety, functional cardiac, and pain disorders: assessment, phenomenology, and treatment. Behav Mod:513-545.
53. Wilhelm FH, Roth WT. 1997. Clinical characteristics of flight phobia. J Anxiety Disord 11:241-261.
54. Wilhelm FH, Roth WT, Sackner M. 2002. The LifeShirt: an advanced system for ambulatory measurement of respiratory and cardiac function. Behav Mod (in press).
55. Wilhelm FH, Trabert W, Roth WT. 2001d. Physiological instability in panic disorder and generalized anxiety disorder. Biol Psychiatry 49:596-605.
56. Wright A, Jones G, Fletcher R, Mackintosh J, Bradwell A. 1985. The Environmental Symptoms Questionnaire in acute mountain sickness. Aviat Space Environ Med 56:572-575.