Terapia cognitivo-comportamental no transtorno de pânico

Abstract

Introduction Panic disorder (PD) is characterized by the presence of sudden anxiety attacks, followed by physical and affective symptoms, fear of having a new attack and avoidance of events or situations in which panic attacks have occurred.1 The course of PD tends to be chronic in the majority of patients, 2,3 and PD is associated with a reduced quality of life and impaired psychosocial functioning.

Cardio-respiratory symptoms in panic disorder: a contribution from cognitive-behaviour therapy

“…Most prior research also restricted surveyed populations to patients without agoraphobia or with light agoraphobia, leaving unknown the efficiency of CBT in patients with more serious agoraphobias 7 . In the population studied, all the patients showed "with agoraphobia" symptoms.…”

“…The patient should try to identify and give a new significance to specific badly-adapted thoughts. The concepts of anticipated an-xiety (AA) and agoraphobic avoidance (PA-aa) 7 are clarified. Patients have the custom of myths in relation to PA, including but not limited to: the patient is instructed to question and contest his or her conjectures and beliefs, concentrate on realistic probabilities, and gather evidence and formulas to deal with events.…”

“…Finally, Interceptive exposure (IE) techniques have the objective of correcting catastrophic interpretations of the physical symptoms (bodily sensations) experienced by the patient. 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 . During the patient's treatment, the techniques of IE and IVE are intended to interact to assist in the remission of the components of cognitive dysfunctions that are linked to agora phobic avoidance and to autonomic symptoms verified in PD.…”

Exposição Interoceptiva para Redução da Ansiedade no Tratamento do Transtorno do Pânico

“…No controle agudo dos AP, o uso de benzodiazepínicos é comum, mas o principal tratamento psicofarmacológico para o TP é o uso de antidepressivos como a Fluoxetina e a Paroxetina, inicialmente em doses baixas até que as crises sejam controladas (Yano, Meyer & Tung, 2003). A Terapia CognitivoComportamental (TCC) individual ou em grupo para o TP possui resultados semelhantes (Salum et al, 2009) e apresenta eficácia melhor do que a farmacologia em longo prazo: 87% dos pacientes continuam sem ataques depois de um ano e 75% a 81% dois anos depois da finalização de TCC breve (Manfro, Heldt, Cordioli, & Otto, 2008). Em um estudo de revisão da literatura, foi visto que não há diferenças significativas quanto à eficácia de intervenções cognitivas, comportamentais e cognitivo-comportamentais, mas é difícil uma comparação mais fidedigna devido aos diferentes desenhos metodológicos dos estudos (Carvalho, Nardi, & Rangé, 2008).…”

“…Os exercícios são praticados inicialmente na presença do terapeuta e indicados como tarefa de casa (Ito, 2001). É importante que, nas exposições a intensidade, semelhança e ansiedade com as sensações que ocorrem em um AP sejam mensuradas (Manfro et al, 2008).…”