Abstract
Objective: To compare patients with panic disorder with agoraphobia treated with cognitive-behavioural therapy (CBT) associated with the medication with patients treated only with medication and verify the behaviour of the cardio-respiratory symptoms of both groups. Methods: Randomized sample in the Psychiatry Institute of the Federal University of Rio de Janeiro, divided in two groups of 25 participants each. Group 1 undertook 10 weekly sessions of CBT with one hour of duration each together with medication. Group 2, Control, were administered medication that only consisted of tricyclic anti-depressants and selective inhibitors of the re-uptake of serotonin. Evaluation instruments were applied at the beginning and to the end of the interventions. Results: According to the applied scales, group 1 showed statistically more significant results than group 2, with: reduction of panic attacks, cardio-respiratory symptoms, anticipatory anxiety, agoraphobia avoidance and fear of bodily sensations. Conclusion: Exposures (in vivo and interoceptive), especially for induction symptom exercises and relaxation, were considered essential to prepare patients with panic disorder to handle future cardio-respiratory symptoms and panic attacks with agoraphobia.
Highlights
Panic disorder (PD)[1] is characterized by the presence of frequent and recurrent acute attacks of anxiety, followed by physical and cognitive symptoms originating from mistaken associations of body sensations (BS) related to a premonition of something serious or of some potential illness
Its methods include psycho education, respiratory re-education (RR) exercises; progressive muscular relaxation (PMR) and cognitive restructuring (CR), which consists of giving a new meaning to the mistaken thought levels, are procedures of great importance in cognitive behavioural therapy (CBT)
Patients treated with CBT had significant improvement compared to the group treated with medication
Summary
Panic disorder (PD)[1] is characterized by the presence of frequent and recurrent acute attacks of anxiety, followed by physical and cognitive symptoms originating from mistaken associations of body sensations (BS) related to a premonition of something serious or of some potential illness. We hypothesized that patients with panic disorder may reduce their number of panic attacks after the cognitive behavioural therapy (CBT)[4] sessions with symptom induction exercises (SIE)[5] and can learn to deal with the cardiorespiratory symptoms such as tachycardia and abnormal breathing. Its methods include psycho education (educational techniques for the individual to learn to deal with anxiety and ample knowledge by the patient of the disorder in question), respiratory re-education (RR) exercises; progressive muscular relaxation (PMR) and cognitive restructuring (CR), which consists of giving a new meaning to the mistaken thought levels, are procedures of great importance in CBT. In vivo exposure (IVE) of the individual to feared places or situations is considered to be the primary intervention applied in the treatment, so that the patient with PD can overcome agoraphobic avoidance[7]
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