Feedback of end-tidal pCO2 as a therapeutic approach for panic disorder.
BACKGROUND
Given growing evidence that respiratory dysregulation is a central feature of panic disorder (PD) interventions for panic that specifically target respiratory functions could prove clinically useful and scientifically informative. We tested the effectiveness of a new, brief, capnometry-assisted breathing therapy (BRT) on clinical and respiratory measures in PD.


METHODS
Thirty-seven participants with PD with or without agoraphobia were randomly assigned to BRT or to a delayed-treatment control group. Clinical status, respiration rate, and end-tidal pCO(2) were assessed at baseline, post-treatment, 2-month and 12-month follow-up. Respiratory measures were also assessed during homework exercises using a portable capnometer as a feedback device.


RESULTS
Significant improvements (in PD severity, agoraphobic avoidance, anxiety sensitivity, disability, and respiratory measures) were seen in treated, but not untreated patients, with moderate to large effect sizes. Improvements were maintained at follow-up. Treatment compliance was high for session attendance and homework exercises; dropouts were few.


CONCLUSIONS
The data provide preliminary evidence that raising end-tidal pCO(2) by means of capnometry feedback is therapeutically beneficial for panic patients. Replication and extension will be needed to verify this new treatment's efficacy and determine its mechanisms.
Meuret
Alicia E
AE
Department of Psychology, Southern Methodist University, 6424 Hilltop Lane, Dallas, TX 75205, United States. ameuret@smu.edu
Wilhelm
Frank H
FH
Ritz
Thomas
T
Roth
Walton T
WT
D000293:Adolescent; D000328:Adult; D001785:Blood Gas Monitoring, Transcutaneous; D001945:Breathing Exercises; D002245:Carbon Dioxide / Q000378:metabolism*; D002648:Child; D004185:Disability Evaluation; D005246:Feedback; D005260:Female; D006801:Humans; D006985:Hyperventilation / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000453:epidemiology / Q000378:metabolism* / Q000628:therapy*; D013990:Tidal Volume / Q000502:physiology*; D014850:Waiting Lists
D002245:Carbon Dioxide