Comparative Study of Respiratory Indices in Anxiety Disorder and Healthy People

Document Type : Original Article

Authors

1 Musculoskeletal Rehabilitation Research Center,Ahvaz Jundishapur University of Medical Science ,Khuzestan, Iran

2 Musculoskeletal Rehabilitation Research Center,Ahvaz Jundishapur University of Medical Science, Khuzestan, Iran

3 Department of Psychiatry, School of Medicine, Ahvaz Jundishapur University, Khuzestan, Iran

4 Department of Statistics and Epidemiology, School of Health, Ahvaz Jundishapur University of Medical Sciences, Khuzestan, Iran

Abstract

Propose:
Generalized anxiety disorder (GAD) is one of the most common psychiatric disorders. So far, no study has examined their respiratory system changes. The purpose of this study was to compare the respiratory pattern indices of healthy individuals and individuals with generalized anxiety disorder.
Methods: 
In the current cross-sectional study, 16 patients with clinical diagnosis of generalized anxiety disorder (GAD) with referral to a psychiatrist were compared with 16 matched healthy individuals. The information of the respiratory system was collected using a chronograph and spirometery. The Pulmonary function tests recorded were FVC, FEV1, FEV1/FVC end-tidal CO2 pressure and respiratory rate were measured using Capnograph. The Nijmegen questionnaire was used to quantify hyperventilation complaints.
Results:
The results of this study showed that anxiety patients had significantly lower levels of FEV1 and FEV1% in comparison with healthy subjects. Exhaled carbon dioxide and respiratory rate were significantly different between the two groups The Niggins questionnaire score was significantly higher in the group of anxiety patients than in the healthy subjects.
Conclusions:
Respiratory pattern in people with generalized anxiety disorder was changed by respiratory volume, increased respiratory rate and decreased CO2. The current findings suggest that assessment of respiratory system in GAD patients can be effective in the early diagnosis and treatment process of breathing problems in physiotherapy centers.

Keywords

References

  1. Hajebi A, Motevalian SA, Rahimi-Movaghar A, Sharifi V, et al. Major anxiety disorders in Iran: prevalence, sociodemographic correlates and service utilization. BMC psychiatry 2018; 18(1): 261.
  2. Grant BF, Hasin DS, Stinson FS, Dawson DA, et al. Prevalence, correlates, co-morbidity, and comparative disability of DSM-IV generalized anxiety disorder in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychological medicine 2005; 35(12): 1747-1759.
  3. Ballenger JC, Davidson JR, Lecrubier Y, Nutt DJ, et al. Consensus statement on generalized anxiety disorder from the International  Consensus  Group  on  Depression and Anxiety. J Clin Psychiatry 2001; 62(1): 53-58.
  4. Katzman MA. Current considerations in the treatment of generalized anxiety disorder. CNS drugs 2009; 23(2): 103-120.
  5. Goodman CC, Fuller KS. Pathology-E-Book: Implications for the Physical Therapist: Elsevier Health Sciences;. 2015: chapter (5) .
  6. Durham RC. Treatment of generalized anxiety disorder. Psychiatry.  2007; 6(5): 183-187.
  7. Barlow DH, Rapee RM, Brown TA. Behavioral treatment of generalized anxiety disorder. Behavior Therapy 1992; 23(4): 551-570.
  8. Patel G, Fancher TL. Generalized anxiety disorder. Annals of internal medicine 2013; 159(11): 1-6.
  9. Han J, Stegen K, Simkens K, Cauberghs M, et al. Unsteadiness of breathing in patients with hyperventilation syndrome and anxiety disorders. European Respiratory Journal. 1997; 10(1): 167-176.
  10. Jack S, Rossiter HB, Warburton CJ, Whipp BJ. Behavioral influences and physiological indices of ventilatory control in subjects with idiopathic hyperventilation. Behavior modification 2003; 27(5): 637-52.
  11. Gilbert C. Interaction of psychological and emotional effects with breathing dysfunction. Multidisciplinary approaches to breathing pattern disorders 2002:111-30.
  12. Umezawa A. Facilitation and inhibition of breathing during changes in emotion.  Respiration and emotion: Springer; 2001: 139-148.
  13. CliftonSmith T, Rowley J. Breathing pattern disorders and physiotherapy: inspiration for our profession. Physical therapy reviews. 2011; 16(1): 75-86.
  14. L. C. Breathing pattern disorders, motor control and low back pain. Osteopath Med 2004; 7(1): 33-40.
  15. Rimington L, Davies D, Lowe D, Pearson M. Relationship between anxiety, depression, and morbidity in adult asthma patients. Thorax 2001; 56(4): 266-271.
  16. Maurer J, Rebbapragada V, Borson S, Goldstein R, et al. Anxiety and depression in COPD: current understanding, unanswered questions, and research needs. Chest 2008; 134(4): 43S-56S.
  17. Withers NJ, Rudkin ST, White RJ. Anxiety and depression in severe chronic obstructive pulmonary disease: the effects of pulmonary rehabilitation. JCRP 1999; 19(6): 362-365.
  18. Eagan TML GA, Eide GE, Bakke PS. The effect of educational level on the incidence of asthma and respiratory symptoms. Respiratory Medicine 2004; 98(8): 730-736.
  19. Tweeddale PM RI, McHardy GJ. Breathing retraining: Effect on anxiety and depression scores in behavioural breathlessness. Journal of psychosomatic research 1994; 38(1): 11-21.
  20. Spitzer RL KK, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of internal medicine 2006; 166(10): 1092-1097.
  21. Han JN SK, De Valck C, Clement J, Van de Woestijne KP. Influence of breathing therapy on complaints, anxiety and breathing pattern in patients with hyperventilation syndrome and anxiety disorders. Journal of psychosomatic research 1996; 41(5): 481-93.
  22. Kaviani H, Mousavi A. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). TUMSJ  2008; 66(2): 136-140.[Persian]
  23. Coates AL, Graham BL, McFadden RG, McParland C, et al. Spirometry in primary care. Canadian respiratory journal 2013; 20(1): 13-22.
  24. Parker FA, inventor; CALDYNE Inc, assignee. Spirometer, display and method. United States patent US 7,172,557. 2007: 6.
  25. Yousefinezhadi B, Ravanbakhsh M, Saadat M, Zakerkish M, Goharpey S. The Impact of Type 2 Diabetes Mellitus on Respiratory System. Journal of Modern Rehabilitation 2018; 12(3): 157-62.
  26. Laffey JG, Kavanagh BP. Hypocapnia. New England Journal of Medicine 2002; 347(1): 43-53.
  27. Gardner WN. The pathophysiology of hyperventilation. Ches 1996; 109(2): 516-534.
  28. Tweeddale P, Rowbottom I, McHardy G. Breathing retraining: Effect on anxiety and depression scores in behavioural breathlessness. Journal of psychosomatic research 1994; 38(1): 11-21.
  29. Carroll D, Phillips AC, Gale CR, Batty GD. Generalized anxiety disorder is associated with reduced lung function in the Vietnam Experience Study. Psychosomatic medicine 2011; 73(8): 716-720.
  30. Leivseth L, Nilsen TI, Mai X-M, Johnsen R, Langhammer A. Lung function and anxiety in association with dyspnoea: the HUNT study. Respiratory medicine 2012; 106(8): 1148-1157.
  31. Suess WM, Alexander AB, Smith DD, Sweeney HW, Marion RJ. The effects of psychological stress on respiration: a preliminary study of anxiety and hyperventilation. Psychophysiology 1980; 17(6): 535-540.
  32. Pittig A, Arch JJ, Lam CW, Craske MG. Heart rate and heart rate variability in panic, social anxiety, obsessive–compulsive, and generalized anxiety disorders at baseline and in response to relaxation and hyperventilation. International journal of psychophysiology 2013;87(1): 19-27.
  33. Wilhelm FH, Trabert W, Roth WT. Physiologic instability in panic disorder and generalized anxiety disorder. Biological psychiatry. 2001 1;49(7):596-605.
  34. Culpepper L. Generalized anxiety disorder and medical illness. The Journal of clinical psychiatry. 2009; 70(2): 20-24.
  35.  Naeinian M, Shaeiri M, Sharifi M, Hadian M. Evaluation of the reliability and validity of the Short Scale of Generalized Anxiety Disorder (GAD-7). 2011, 3(4); 41-50.  [Persian]
  36. Ravanbakhsh M, Nargesi M, Raji H, Shoushtari MH. Reliability and validity of the Iranian version of Nijmegen Questionnaire in Iranians with asthma. Tanaffos 2015; 14(2): 121.
  37.  Erdfelder E, Faul F, Buchner A. GPOWER: A general power analysis program. Behavior research methods, instruments, & computers 1996; 28(1): 1-11.

Journal of Paramedical Sciences & Rehabilitation
Volume 9, Issue 4
March 2021
Pages 72-79

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