Psychological treatment of comorbid asthma and panic disorder: A pilot study

Abstract

We evaluated two protocols for treating adults with comorbid asthma and panic disorder. The protocols included elements of Barlow's panic control therapy and elements of Barlow's "panic control therapy" and several asthma education programs, as well as modules designed to teach participants how to differentiate asthma and panic symptoms, and how to apply specific home management strategies for each. Fifty percent of subjects dropped out of a 14-session protocol by the eighth session; however, 83% of patients were retained in an eight-session protocol. Clinical results were mostly equivalent: significant decreases of >50% in panic symptoms, clinically significant decreases in asthma symptoms, improvement in asthma quality of life, and maintenance of clinical stability in asthma. Albuterol use decreased significantly in the 14-session protocol and at a borderline level I the 8-session protocol, while pulmonary function was maintained. A controlled evaluation of this procedure is warranted.

Asthma-related comorbidities

“…Psychological interventions in patients with asthma, particularly children, remain uncertain, their effects being quite variable [138][139][140][141]. Yorke et al performed a systematic review on the efficacy of psychological interventions in asthma [142].…”

Influence of comorbid conditions on asthma

“…Although studies have indicated that treatment of panic disorders can improve asthma outcomes, the authors of a Cochrane meta-analysis on the role of psychological interventions for children with asthma were unable to draw firm conclusions about the efficacy of this approach [70][71][72][73]. Studies reporting positive effects were usually conducted by specialists treating well-defined psychopathological comorbidities, whereas studies of psychoeducational interventions carried out by nonspecialists seemed less effective.…”

Asthma and psychological dysfunction

“…However, there were some suggestions of improved asthma outcomes associated with a number of interventions targeted on reducing anxiety and depression such as relaxation therapy, CBT, and biofeedback. Recent pilot studies in patients with co-morbid anxiety and depression have reported improved asthma outcomes in patients undergoing panic control programmes 53 or treatment with antidepressant medication. 54 Both these studies were small and preliminary so further research is needed.…”