TREATMENT FOR COMORBID ASTHMA AND PANIC DISORDER

一种针对合并惊恐障碍（PD）和哮喘患者的手动治疗方法将被开发出来。帕金森病在哮喘患者中比在普通人群中更为常见，有证据表明哮喘和帕金森病可能相互加剧。这是通过生理机制（自主神经过度反应、过度通气、药物作用）、认知机制（对呼吸相关身体感觉的恐惧、对哮喘和恐慌症状的错误区分）和行为机制（不适当的行为和药物干预）发生的。该项目将整合经过验证的恐慌（“恐慌控制疗法”）和哮喘（“哮喘教育”）的手动治疗方法，并为共病组添加特别重要的组成部分（例如，区分恐慌和哮喘症状以及适应性哮喘特异性恐慌和适应性不良广泛性恐慌，调和哮喘和恐慌治疗中表面上相互矛盾的建议）。在第一年，将扩充手册并对10个共病科目进行测试。在接下来的两年中，将对40名共病患者进行改进和试点测试，采用等候名单对照和6个月的随访。主要结局指标将是高/低PD终末状态功能和哮喘严重程度改善的指标。并对一些探索性措施进行了分析。

A manualized treatment approach will be developed for people with comorbid panic disorder (PD) and asthma. PD is much more common among asthmatics than in the general population, and there is evidence that asthma and PD may mutually exacerbate each other. This occurs through mechanisms that are physiological (autonomic hyperreactivity, hyperventilation, effects of medications), cognitive (fear of respiratory-linked body sensations, faulty discrimination between asthma and panic symptoms), and behavioral (inappropriate behavioral and pharmacological interventions). This project will integrate well-validated manualized treatment approaches for panic ("panic control therapy") and asthma ("asthma education"), and add components of particular importance to the comorbid group (e.g., discriminating between panic and asthma symptoms and between adaptive asthma-specific panic and maladaptive generalized panic, reconciling superficially contradictory recommendations given in asthma and panic therapies). During the first year a manual will be expanded and tested on 10 comorbid subjects. During the next two years, it will be refined and pilot tested on 40 comorbid subjects, using a waiting list control and a 6-month follow-up. The principal outcome measures will be indices of high/low PD end-state functioning and improvement in asthma severity. A number of exploratory measures also will be analyzed.