Respiratory Training Prior to Exposure in vivo in the Treatment of Panic Disorder with Agoraphobia: Efficacy and Predictors of Outcome

1995 ◽  
Vol 29 (1) ◽  
pp. 104-113 ◽  
Author(s):  
Edwin de Beurs ◽  
Alfred Lange ◽  
Pieter Koele ◽  
Richard van Dyck
Keyword(s):  
Treatment Outcome ◽  
Panic Disorder ◽  
Prognostic Value ◽  
Panic Attacks ◽  
Self Report ◽  
Number Of Patients ◽  
Exposure In Vivo ◽  
Respiratory Training

Thirty-two patients suffering from panic disorder with agoraphobia were treated with repeated hyperventilation provocations and respiratory training, followed by exposure in vivo. The treatment was evaluated with a comprehensive set of outcome measures, including self-report questionnaires, a multitask behavioural avoidance test and continuous monitoring of panic. The treatment was found effective for the majority of patients in diminishing the frequency of panic attacks and agoraphobic avoidance. The clinical relevance of the treatment effect was evidenced by the considerable number of patients that recovered. The effect of the treatment was sustained over a three and six month follow-up period. The prognostic value of a number of variables for treatment outcome was also investigated. Three variables accounted for the majority of the variance in treatment outcome: a higher pretreatment level of agoraphobic complaints, use of psychotropic medication and a longer duration of the disorder were associated with poorer outcome. Other variables, such as the therapeutic relationship and the quality of the marital bond, had no prognostic value.

Respiratory Control: Its Contribution to the Treatment of Panic Attacks

1989 ◽  
Vol 154 (2) ◽  
pp. 232-236 ◽  
Author(s):  
George A. Hibbert ◽  
Michael Chan
Keyword(s):  
Respiratory Control ◽  
Specific Effect ◽  
Provocation Test ◽  
Placebo Treatment ◽  
Panic Attacks ◽  
Self Report ◽  
Observer Ratings ◽  
Controlled Breathing ◽  
Respiratory Training

Patients who experienced panic attacks, with or without avoidance, were treated for two weeks with either training in controlled breathing or a placebo treatment. Subsequently, both groups received a limited period of conventional anxiety treatments, most commonly in vivo exposure. Patients were subdivided into ‘hyperventilators' and ‘non-hyperventilators' on the basis of the conventional provocation test. Observer ratings of anxiety showed a greater improvement for the group that received breathing training, but there was no evidence that ‘hyperventilators' benefited more from respiratory training than ‘non-hyperventilators'. Self-report measures of anxiety, avoidance, and depression/dysphoria showed no difference between treatments. These findings suggest that training in controlled breathing is not of specific benefit for those identified as ‘hyperventilators' by the provocation test, but that it may have a non-specific effect in the treatment of patients with panic attacks.

Pharmacologic Treatment of Panic Disorder

CNS Spectrums ◽  
2005 ◽  
Vol 10 (S12) ◽  
pp. 25-31
Author(s):  
Julie C. Stevens ◽  
Mark H. Pollack
Keyword(s):  
Quality Of Life ◽  
Treatment Outcome ◽  
Panic Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Panic Attacks ◽  
Pharmacologic Treatment ◽  
Comorbid Conditions ◽  
Anticipatory Anxiety ◽  
Norepinephrine Reuptake

AbstractPanic disorder, frequently complicated by agoraphobia in the clinical setting, is a relatively common disorder that is associated with significant morbid burden and dysfunction in affected individuals. PD treatment is focused on the reduction of panic attacks, avoidance behavior, and anticipatory anxiety, as well as the resolution of comorbid conditions, with the goal of normalizing function and improving overall quality of life. Antidepressants, including the selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors, as well as benzodiazepines, are commonly used as primary pharmacotherapies for the treatment of PD, with a variety of other novel interventions potentially useful as well, to optimize treatment outcome.

Respiratory training prior to exposure in vivo in the treatment of panic disorder with agoraphobia

1990 ◽  
Vol 31 (3) ◽  
pp. 285 ◽  
Author(s):  
Edwin de Beurs ◽  
Alfred Lange ◽  
Richard Van Dijck ◽  
Pieter Koele
Keyword(s):  
Panic Disorder ◽  
Exposure In Vivo ◽  
Respiratory Training

scholarly journals Substance Use and Mental Health Outcomes for Comorbid Patients in Psychiatric Day Treatment

2009 ◽  
Vol 3 ◽  
pp. SART.S3462
Author(s):  
Stephen Magura ◽  
Andrew Rosenblum ◽  
Thomas Betzler
Keyword(s):  
Quality Of Life ◽  
Psychological Distress ◽  
Drug Use ◽  
Drug Users ◽  
Day Treatment ◽  
Self Report ◽  
Psychological Status ◽  
Number Of Patients ◽  
Psychiatric Day Treatment

The study's purpose was to determine treatment outcomes for patients who present with drug use vs. those presenting with no drug use at admission to a psychiatric day treatment program. Consecutively admitted patients completed confidential interviews which included psychological distress and quality of life measures and provided urine specimens for toxicology at admission and six month follow-up. Subjects positive by past 30 day self-report or urinalysis were categorized as drug users. Major psychiatric diagnoses were: major depression 25%; bipolar, 13%; other mood 13%; schizoaffective 13%; schizophrenia 13%. Drug use at admission was: cocaine 35%; marijuana 33%; opiates 18%, (meth)amphetamines, 6% For each of these drugs, the percentage of patients positive at admission who remitted from using the drug significantly exceeded the percentage negative at baseline who initiated using the drug. Overall, there were significant decreases in psychological distress and significant improvement on quality of life, but no change on positive affect. There were no significant differences between drug users and non-drug users on symptom reduction and improvement in quality of life. Psychiatric day treatment appears to benefit comorbid patients by reducing the net number of patients who actively use certain common drugs and by improving psychological status and quality of life to the same degree as for non-drug using patients.

Quality of Life and Treatment Outcome in Panic Disorder: Cognitive Behavior Group Therapy Effects in Patients Refractory to Medication Treatment

2006 ◽  
Vol 75 (3) ◽  
pp. 183-186 ◽  
Author(s):  
Elizeth Heldt ◽  
Carolina Blaya ◽  
Luciano Isolan ◽  
Leticia Kipper ◽  
Betina Teruchkin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Treatment Outcome ◽  
Group Therapy ◽  
Panic Disorder ◽  
Cognitive Behavior ◽  
Medication Treatment

Changes in quality of life following cognitive-behavioral group therapy for panic disorder

2010 ◽  
Vol 25 (1) ◽  
pp. 8-14 ◽  
Author(s):  
M. Rufer ◽  
R. Albrecht ◽  
O. Schmidt ◽  
J. Zaum ◽  
U. Schnyder ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Group Therapy ◽  
Panic Disorder ◽  
Well Being ◽  
Panic Attacks ◽  
Cognitive Behavioral ◽  
Cognitive Behavioral Group Therapy ◽  
Sf 36 ◽  
Behavioral Group

AbstractBackgroundData about quality of life (QoL) are important to estimate the impact of diseases on functioning and well-being. The present study was designed to assess the association of different aspects of panic disorder (PD) with QoL and to examine the relationship between QoL and symptomatic outcome following brief cognitive-behavioral group therapy (CBGT).MethodsThe sample consisted of 55 consecutively recruited outpatients suffering from PD who underwent CBGT. QoL was assessed by the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) at baseline, post-treatment and six months follow-up. SF-36 baseline scores were compared with normative data obtained from a large German population sample.ResultsAgoraphobia, disability, and worries about health were significantly associated with decreased QoL, whereas frequency, severity and duration of panic attacks were not. Treatment responders showed significantly better QoL than non-responders. PD symptom reduction following CBGT was associated with considerable improvement in emotional and physical aspects of QoL. However, the vitality subscale of the SF-36 remained largely unchanged over time.ConclusionsOur results are encouraging for cognitive-behavior therapists who treat patients suffering from PD in groups, since decrease of PD symptoms appears to be associated with considerable improvements in QoL. Nevertheless, additional interventions designed to target specific aspects of QoL, in particular vitality, may be useful to enhance patients’ well-being.

The effect of Citalopram in panic disorder

1997 ◽  
Vol 170 (6) ◽  
pp. 549-553 ◽  
Author(s):  
A. G. Wade ◽  
U. Lepola ◽  
H. J. Koponen ◽  
V. Pedersen ◽  
T. Pedersen
Keyword(s):  
Panic Disorder ◽  
Serotonin Reuptake ◽  
Tricyclic Antidepressants ◽  
Rating Scales ◽  
Panic Attacks ◽  
Tolerability Profile ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Parallel Group ◽  
Number Of Patients

BackgroundCitalopram is a serotonin reuptake inhibitor which has been demonstrated to be highly selective and with a superior tolerability profile to the classical tricyclic antidepressants. This study was designed to test whether there was any difference in eff icacy in the management of panic disorder (PD) between Citalopram and placebo.MethodThis was a double-blind, placebo and clomipramine controlled, parallel group eight-week study. A total of 475 patients with PD, with or without agoraphobia, were randomised to treatment with either placebo, clomipramine 60 or 90 mg/day, or Citalopram 10 or 15 mg/day, 20 or 30 mg/day, or 40 or 60 mg/day. Doses were increased over the first three weeks, stabilised during the fourth week and fixed between weeks five and eight.ResultsTreatment with Citalopram at 20 or 30 mg, 40 or 60 mg and clomipramine were significantly superior to placebo, judged by the number of patients free of panic attacks in the week prior to the final assessment. All rating scales examined suggested that Citalopram 20 or 30 mg was more effective than Citalopram 40 or 60 mg.ConclusionThe most advantageous benefit/risk ratio for the treatment of PD was associated with citalopram 20 or 30 mg/day.

scholarly journals THE PSYCHOBIOLOGICAL CORRELATES OF PANIC ATTACKS DURING IN VIVO EXPOSURE

1999 ◽  
Vol 27 (4) ◽  
pp. 353-367 ◽  
Author(s):  
Nigar G. Khawaja ◽  
Tian P. S. Oei
Keyword(s):  
Panic Disorder ◽  
Case Studies ◽  
Panic Attacks ◽  
Central Component ◽  
Clear Cut ◽  
Cognitive Theories

This study examined in detail the psychobiological correlates of panic attacks experienced in panic disorder with agoraphobia. The cognitions, affect, and physiology of the six patients were monitored during in vivo exposure to their phobic situations. The results from these case studies showed that catastrophic cognitions are the key component of panic attacks. However, there was no clear-cut evidence to support an interaction among cognitions, affect, and physiology, which has been postulated by cognitive theories to be the central component of panic attacks and panic disorder with agoraphobia.

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