BMJ 2001;323:631 ( 15 September )

Letters

Dysfunctional breathing and asthma

    Panic disorder needs to be considered
    Trial shows benefits of Buteyko breathing techniques
    Author's reply

Panic disorder needs to be considered

The first 150 words of the full text of this article appear below.

EDITOR---Thomas et al report an appreciable prevalence of dysfunctional breathing in adults with asthma and discuss the scope for wider use of breathing therapy.1 Neither Thomas et al nor Keeley and Osman in their editorial2 consider whether such symptoms might occur equally often in the normal population or represent panic attacks and panic disorder, well defined entities common in otherwise healthy people. Without a control group their study is incapable of identifying the prevalence of dysfunctional breathing associated specifically with asthma.

Dysfunctional breathing and the hyperventilation syndrome are by no means the same as panic syndromes, but overlap between them may be considerable. Thomas et al acknowledge limitations of the Nijmegen questionnaire.3 This instrument cannot differentiate the "chimeric" hyperventilation syndrome from panic attacks and panic disorder. The 16 items in the Nijmegen questionnaire include "anxiety," "feeling tense," and nine of the 13 panic attack symptoms listed in the Diagnostic and . . . [Full text of this article]
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