title: Respiratory biofeedback-assisted therapy in panic disorder.
abstract: The authors describe a new methodologically improved behavioral treatment for panic patients using respiratory biofeedback from a handheld capnometry device. The treatment rationale is based on the assumption that sustained hypocapnia resulting from hyperventilation is a key mechanism in the production and maintenance of panic. The brief 4-week biofeedback therapy is aimed at voluntarily increasing self-monitored end-tidal partial pressure of carbon dioxide (PCO2) and reducing respiratory rate and instability through breathing exercises in patients' environment. Preliminary results from 4 patients indicate that the therapy was successful in reducing panic symptoms and other psychological characteristics associated with panic disorder. Physiological data obtained from home training, 24-hour ambulatory monitoring pretherapy and posttherapy, and laboratory assessment at follow-up indicate that patients started out with low resting PCO2 levels, increased those levels during therapy, and maintained those levels at posttherapy and/or follow-up. Partial dissociation between PCO2 and respiratory rate questions whether respiratory rate should be the main focus of breathing training in panic disorder.
authors.affiliation: Stanford University, Palo Alto, USA. alicia.meuret@stanford.edu
authors.forename: A E
authors.initials: AE
authors.lastname: Meuret
authors.forename: F H
authors.initials: FH
authors.lastname: Wilhelm
authors.forename: W T
authors.initials: WT
authors.lastname: Roth
mesh_terms: D000328:Adult; D001676:Biofeedback, Psychology; D002245:Carbon Dioxide / Q000097:blood; D005260:Female; D006801:Humans; D006985:Hyperventilation / Q000523:psychology / Q000628:therapy; D008297:Male; D016584:Panic Disorder / Q000523:psychology / Q000628:therapy*; D012119:Respiration; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide