Panic Disorder (PD) has been associated with abnormalities in the respiratory system for a long time, and treatment programs aimed at reversing these abnormalities have been developed. Panicogenic effects of biological challenges have been shown to be altered after successful treatment. Furthermore, there is evidence that anxious non-PD patients show similar responses to these challenges and hence may benefit from some kind of breathing training (BT). To test these assumptions, we recruited 45 PD patients, 39 Episodic Anxiety (EA) patients who suffered from subclinical panic attacks, and 20 non-anxious controls (NAC). Patients were randomized to one of two versions of a 4-week therapy with BT, either lower or raise end-tidal pCO2, or a waiting list (WL). Before and after treatment, participants underwent in randomized order a Voluntary Hypoventilation (VHO) test and a Voluntary Hyperventilation (VHT) test in which they were asked to either lower or raise their pCO2 while psychophysiological measures were recorded. Each test consisted of 3 segments: 1 min baseline, 3 min paced breathing, and 8 min recovery. Before treatment, PD and EA patients were more anxious, distressed, tense, and worried than NAC, and felt more dizziness, chest pain, and nausea during the laboratory assessment. However, increases in psychological symptoms or physiological sensations from baseline to the paced breathing segments were not different between groups. The two tests produced similar changes except that anxiety and dizziness increased more during the VHT than VHO. We replicated baseline breathing abnormalities previously reported for PD patients, namely greater respiration rate, tidal volume instability, and number of sighs. However, analyses did not find that patients recovered slower to either challenge. After treatment, both therapies improved on the main outcome measure. Furthermore, BT affected baseline pCO2, resulting in lower levels in the hypocapnic groups and higher levels in the hypercapnic groups without affecting any other measures. We conclude that baseline respiratory abnormalities are specific to PD. However, data suggest that the manipulations might have been too weak to elicit other previously reported group differences. Breathing training was equally effective for the lower and raise BT. Hence, factors unrelated to modifying one’s pCO2 must have accounted for the symptomatic improvement. Breathing training should not be restricted to PD but be applied to all patients suffering from anxiety attacks.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:23998 |
| Date | 04 December 2007 |
| Creators | Wollburg, Eileen |
| Contributors | Brocke, Burkhard, Roth, Walton T., Hoyer, Jürgen |
| Publisher | Technische Universität Dresden |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | doc-type:doctoralThesis, info:eu-repo/semantics/doctoralThesis, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
Page generated in 0.0023 seconds