Meuret A E, Wilhelm F H, Roth W T
Stanford University, Palo Alto, USA.
Behav Modif. 2001 Sep;25(4):584-605. doi: 10.1177/0145445501254006.
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.
作者描述了一种针对惊恐症患者的新的行为治疗方法，该方法在方法学上有所改进，使用来自手持式二氧化碳测量仪的呼吸生物反馈。治疗原理基于这样一种假设，即过度通气导致的持续性低碳酸血症是惊恐发作和维持的关键机制。为期4周的简短生物反馈疗法旨在通过患者环境中的呼吸练习，自愿提高自我监测的呼气末二氧化碳分压（PCO2），并降低呼吸频率和不稳定性。4名患者的初步结果表明，该疗法成功减轻了惊恐症状以及与惊恐障碍相关的其他心理特征。从家庭训练、治疗前和治疗后的24小时动态监测以及随访时的实验室评估中获得的生理数据表明，患者开始时静息PCO2水平较低，治疗期间该水平升高，并在治疗后和/或随访时维持这些水平。PCO2与呼吸频率之间的部分分离对呼吸频率是否应成为惊恐障碍呼吸训练的主要重点提出了质疑。
