Psychosomatic symptoms and breathing pattern

Abstract

Objective: Study of the links between breathing pattern, negative affectivity, and psychosomatic complaints at rest and following hyperventilation. Methods: In 819 patients with anxiety and somatoform disorders and 159 healthy subjects, self-reported symptoms, breathing pattern, and end-tidal CO2 concentration (FetCO2) were recorded during rest and following a hyperventilation provocation test (HVPT). The relationship between disorder category, symptoms, age, and score of STAI-trait (as a measure of negative affectivity) on the one hand, and breathing pattern on the other was investigated, separately in men and women. Results: Anxiety disorders, and to a lesser extent, somatoform disorders, were characterized by breathing instability (progressive decrease of FetCO2 at rest during mouthpiece breathing, delayed recovery of FetCO2 following HVPT), the mean values of respiratory frequency, and FetCO2 being modulated by STAI-trait. After grouping the symptoms into independent factors, links were observed between symptoms and breathing pattern, independently from the presence of an anxiety or somatoform disorder. Conclusion: Some symptom factors appeared to be related to a lower FetCO2 during hyperventilation, others likely directly influenced the breathing pattern. Among those, mainly respiratory symptoms were accompanied by a reduction of FetCO2 at rest, with slower recovery of FetCO2 following HVPT. The latter was observed also in the presence of marked anxiety. In contrast, subjects complaining of dizziness, fainting, and paresthesias in daily life presented higher values of FetCO2 following HVPT, probably due to a voluntary braking of ventilation during HVPT. © 2000 Elsevier Science Inc. All rights reserved.