TREATMENT FOR COMORBID ASTHMA AND PANIC DISORDER

将为患有惊恐障碍(PD)和哮喘的人开发一种机械化的治疗方法。帕金森病在哮喘患者中比在普通人群中更常见，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(自主神经高反应性、过度换气、药物的影响)、认知机制(对与呼吸有关的身体感觉的恐惧、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。该项目将整合有效的恐慌(“恐慌控制疗法”)和哮喘(“哮喘教育”)的人工治疗方法，并增加对共病组特别重要的内容(例如，区分恐慌和哮喘症状，以及适应性哮喘特有的恐慌和适应不良的全身性恐慌，调和哮喘和恐慌疗法中表面上相互矛盾的建议)。在第一年里，将在10个并存的科目上扩充和测试一本手册。在接下来的两年里，它将在40名合并疾病的受试者上进行完善和试点测试，使用等待名单对照和6个月的跟踪调查。主要的结果指标将是高/低PD终态功能指数和哮喘严重程度的改善。还将对一些探索性措施进行分析。

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.