TREATMENT FOR COMORBID ASTHMA AND PANIC DISORDER

将为患有惊恐障碍（PD）和哮喘的患者开发一种手动治疗方法。 PD在哮喘患者中比在普通人群中更常见，并且有证据表明哮喘和PD可能相互加重。这通过生理机制（自主神经高反应性、过度换气、药物作用）、认知机制（对与哮喘相关的身体感觉的恐惧、哮喘和恐慌症状之间的错误区分）和行为机制（不适当的行为和药物干预）发生。该项目将整合经充分验证的恐慌（“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成分（例如，区分惊恐和哮喘症状以及适应性哮喘特异性惊恐和适应不良的普遍惊恐，调和哮喘和惊恐治疗中给出的表面上矛盾的建议）。 在第一年，将扩大手册，并对10名共病受试者进行测试。 在接下来的两年里，它将被完善，并在40名共病受试者中进行试点测试，使用等待列表控制和6个月的随访。 主要结局指标为高/低PD终末状态功能和哮喘严重程度改善的指标。 还将分析一些探索性措施。

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.