Panic disorder following torture by suffocation is associated with predominantly respiratory symptoms

Background. We previously reported that in panic disorder a history of near-suffocation is associated with predominantly respiratory panic attacks. It might be hypothesized that the near-suffocation experienced in certain kinds of torture is also associated with the development of predominantly respiratory panic attacks. Methods. A sample of patients who had experienced torture (N = 14) was drawn from an Anxiety Disorders Clinic in South Africa. Subjects were questioned about symptoms of panic disorder, posttraumatic stress disorder and depression. Results. Patients with a history of torture by suffocation were more likely than other patients to complain of predominantly respiratory symptoms during panic attacks. These patients also demonstrated higher levels of depressive symptoms. Conclusions. While various interpretations of the data can be made, it is possible that torture by suffocation is associated with a specific symptomatic profile. Were such an association to be replicated, this would perhaps support the suffocation alarm hypothesis of panic disorder and provide evidence that specific environmental factors play a role in the development of this alarm.