End-Tidal CO2 in Patients with Panic Disorder, Stress-Related or Functional Syndromes, Versus Healthy Controls 2022 Ramakers et al

[Andy]

Abstract

A dysregulated autonomic stress physiology is hypothesized to play an important role in the etiology and perpetuation of somatic symptoms that cannot be (fully) explained by an organic disease. The aim of this study was to focus on the role of the respiratory system.

We examined end-tidal CO2 concentration (PetCO2) in healthy controls (n = 30), patients with panic disorder (n = 36), and patients with stress-related (overstrain; n = 35, burnout; n = 44) or functional syndromes [fibromyalgia (FM) and/or chronic fatigue syndrome (CFS); n = 36]. Participants went through a rest period and a respiratory challenge with recovery, whilst PetCO2 was continuously monitored by a capnograph.

Taken together, our results suggest: (1) an overactive respiratory system to be a possible transdiagnostic underlying factor of overstrain, burnout, and panic disorder, and (2) the presence of a less active respiratory fight-flight response in the more chronic and severe functional syndromes (FM/CFS).

Paywall, https://link.springer.com/article/10.1007/s10484-022-09573-z

 

[rvallee]

A dysregulated autonomic stress physiology

symptoms that cannot be (fully) explained by an organic disease

Yes. Makes sense. Up is down if you really think about it. (Or if you add a major hand-waving in parentheses, I guess). Or I guess the "dysregulation" must be spiritual, or something like that.

(It's going to be functional overlays in parentheses for a while, is it?)

 

[RedFox]

symptoms that cannot be (fully) explained by an organic disease

I can't believe they still use terms like this. Not understanding what's wrong is equated with nothing being wrong.

 

[Ravn]

Putting aside concerns over "functional" classifications and interpretations for a moment, this study appears to have found a difference between the stress/anxiety type disorders and FM/ME.

This finding, if solid, would logically contradict:

1) the simplistic BPS trope that ME=anxiety, and

2) the popular hypothesis shared by some BPS and some more biomedical researchers that ME=stress response stuck on 'on' (where stress can be physical, orthostatic, infectious, psychological, etc).