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De hyperventilatieprovocatietest: een invalide test voor een onhoudbaar begrip?

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Van hyperventilatie wordt aangenomen dat het verschillende lichamelijke en psychische klachten kan veroorzaken, het zogenaamde HyperventilatieSyndroom (HVS). Symptoomherkenning tijdens een hyperventilatie–provocatietest (HVPT) is het meest gebruikte criterium om HVS te diagnosticeren, maar aanvullende fysiologische criteria en symptoomcriteria worden in de literatuur voorgesteld. De concordantie tussen verschillende diagnostische criteria voor HVS wordt in deze studie onderzocht. Achtenveertig psychiatrische patiënten met een paniekstoornis en negentig lichamelijk zieke patiënten met symptomen die wijzen op HVS ondergingen een HVPT. Er bestond een sterke onderlinge samenhang tussen de verschillende symptoomcriteria en de fysiologische criteria. Daarentegen werd er hoegenaamd geen verband gevonden tussen symptoomcriteria enerzijds en fysiologische criteria anderzijds. Symptoomherkenning hing significant samen met angstdispositie, agorafobie en depressiviteit. Deze gegevens ondermijnen de validiteit van de HVPT alsmede het begrip HVS. De resultaten zijn meer in overeenstemming met een cognitieve benadering van paniek, waarin de HVPT wordt gezien als een aspecifieke stressor waarbij meer angstige patiënten een paniekaanval anticiperen.

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Notes

  1. ns niet–significant, * p < 0,05, ** p < 0,01, *** p < 0,001

  2. ns niet–signifcant, * p < 0,05, ** p < 0,01, *** p < 0,001

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  1. http://www.bsl.nl/shop/directieve-therapie-0167-238x.html

    Philip Spinhoven

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  1. Philip Spinhoven
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  2. Evert J. Onstein
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  3. Peter J. Sterk
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  4. Désiree Le Haen–Versteijnen
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Abstract

Hyperventilation is assumed to produce a set of somatic and psychological symptoms, the so–called Hyperventilation Syndrome (HVS). Recognition of symptoms during the hyperventilation provocation test (HVPT) is the most widely used criterion for diagnosing HVS, but additional physiological and symptom criteria have been proposed in the literature. The concordance of various diagnostic criteria for HVS is investigated in the present study.

Forty–eight psychiatric patients with panic disorder and ninety somatic patients with symptoms suspective of HVS performed a HVPT. There was a strong interrelationship between the various symptom criteria as well as the physiological criteria. However, almost no association between symptom and physiological HVS criteria was found. Symptom recognition was significantly related to trait anxiety, agoraphobia and depression. These data do not only question the validity of the HVPT, but also of the concept of HVS. The results are more consistent with a cognitive approach to panic in which the HVPT is seen as an aspecific stressor during which more anxious patients anticipate an anxiety attack.

Dr. P. J. Sterk, arts–longfysioloog, is verbonden aan het Longfunctielaboratorium van de vakgroep Longziekten van het Academische Ziekenhuis Leiden.

Drs. D. Le Haen–Versteijnen, psycholoog.

Correspondentieadres: Philip Spinhoven, Vakgroep Psychiatrie, Postbus 1251, 2340 BG Oegstgeest.

Dr. Ph. Spinhoven, psycholoog, is verbonden aan de vakgroep Psychiatrie van de RU Leiden.

E. J. Onstein, psychiater, werkt bij dezelfde vakgroep.

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Spinhoven, P., Onstein, E.J., Sterk, P. et al. De hyperventilatieprovocatietest: een invalide test voor een onhoudbaar begrip?. DITH 12, 131–136 (1992). https://doi.org/10.1007/BF03060000

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