Olfactory-triggered panic attacks among Cambodian refugees attending a psychiatric clinic

Gen Hosp Psychiatry. 2004 Sep-Oct;26(5):390-7. doi: 10.1016/j.genhosppsych.2004.04.007.


Olfactory panic attacks have not been systematically assessed in a psychiatric population by any previous studies. Among Cambodian refugees attending a psychiatric clinic, the present investigation determines the following: (a) 1-month current prevalence of olfactory-triggered panic attacks, (b) associated psychopathology (Hopkins Symptom Checklist and the Structured Clinical Interview for DSM-IV-diagnosed posttraumatic stress disorder [PTSD]), and (c) frequency in events of olfactory panic of catastrophic cognitions (Panic Attack Cognitions Scale [PACQ]) and flashbacks (Clinician-Administered PTSD flashback scale). Forty-five percent of 100 consecutive psychiatric patients were found to have suffered an olfactory-triggered panic attack in the previous month; having current olfactory panic attacks was highly correlated with psychopathology (e.g., to PTSD diagnosis: and chi(2)=50.0; df=1; p<.001); and during olfactory-triggered panic attacks, catastrophic cognitions and flashbacks were common. Possible mechanisms for generation of high rates of olfactory-triggered panic attacks in this population are discussed (the "traumatic memory/catastrophic cognitions/interoceptive conditioning/escalating arousal" or "TCIE" model of panic generation) as are treatment implications.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Association
  • Cambodia / ethnology
  • Comorbidity
  • Cross-Sectional Studies
  • Defense Mechanisms
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Interview, Psychological
  • Life Change Events*
  • Male
  • Massachusetts
  • Mental Recall
  • Middle Aged
  • Odorants*
  • Panic Disorder / diagnosis
  • Panic Disorder / epidemiology*
  • Panic Disorder / psychology
  • Psychopathology
  • Refugees / psychology*
  • Smell*
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Post-Traumatic / psychology