Original Research Article
Year: 2016 | Month: November | Volume: 6 | Issue: 11 | Pages: 109-117
Spirometric Changes in Hyperventilating Patients Attending Routine Psychiatric OPD: A Multidisciplinary Hospital Based Study
Javid Ahmad Malik1, Ab Majid Gania2, Junaid Nabi2, Shabir Ahmad Lone1, Ajaz Ahmad Suhaff2, Ramees Mohiud Din Mir1, A W Khan1
1Department of Chest Medicine, 2Department of Psychiatry,
SKIMS Medical College, Bemina, Srinagar.
Corresponding Author: Javid Ahmad Malik
ABSTRACT
Hyperventilation is breathing in excess of metabolic requirements and associated with reduction in arterial pco2 (paco2) respiratory alkalosis, and a wide range of symptoms. The association between hyperventilation and heightened response to carbon dioxide inhalation is well documented. During co2 inhalation, patients with panic disorder report more anxiety and dyspnea than normal subjects. Many psychosomatic syndromes have been described in the past in which hyperventilation has a variable and uncertain role. It was first used in 1938 to describe patients with the somatic symptoms of both hypocapnia and anxiety. Most physicians regard hyperventilation as synonymous with anxiety and thus invariably within the provision of the psychiatrist, but anxiety many be absent or secondary to hyperventilation. Since there is paucity of relevant data from Kashmir, this study was designed to find the co morbidity in patients of COPD and Asthma in a tertiary care teaching hospital in Srinagar, Kashmir.
Methods: Thirty successive patients presents with history of hyperventilation who fulfilled inclusion and exclusion criteria were taken up for the study and administered the Hamilton Anxiety rating scale (HAM-A) scales for evaluation of anxiety spectrum disorders. Each patient was informed about the purpose of interview; his/her consent was obtained and strict confidentiality was ensured. General description, demographic data and psychiatric history were recorded using semi structured Proforma and HAM-A.
Results: Out of thirty cases of hyperventilation, 50% of the patients were in the age group of 61-80 followed by 30% in age group of 31-45 years. This could suggest that hyperventilation affects old age as well middle age. There were predominantly more females (6o%) than males (40%) in our study. Representations of gender, occupation and marital status have been found to be in accordance with socio-demographic profile of our country. Out of thirty cases of hyperventilation 50% were farmers, 30% of the patients were students and 60% had history of smoking. This reflects that smoking as well as occupational hazard is factors of importance in hyperventilation.
Discussion: Obstruction was found in 30% of patients while as 70% were normal on Spirometry. Panic disorder accounted for 50% of cases followed by generalized anxiety disorder in 40% of sample size.
Key words: Hyperventilation, Spirometry, panic disorder, generalized anxiety disorder.