RESPIRATORY TRAINING PRIOR TO EXPOSURE IN-VIVO IN THE TREATMENT OF PANIC DISORDER WITH AGORAPHOBIA - EFFICACY AND PREDICTORS OF OUTCOME

Thirty-two patients suffering from panic disorder with agoraphobia wer e treated with repeated hyperventilation provocations and respiratory training, followed by exposure in vivo. The treatment was evaluated wi th a comprehensive set of outcome measures, including self-report ques tionnaires, a multi-task behavioural avoidance test and continuous mon itoring of panic. The treatment was found effective for the majority o f patients in diminishing the frequency of panic attacks and agoraphob ic avoidance. The clinical relevance of the treatment effect was evide nced by the considerable number of patients that recovered. The effect of the treatment was sustained over a three and six month follow-up p eriod. The prognostic value of a number of variables for treatment out come was also investigated. Three variables accounted for the majority of the variance in treatment outcome: a higher pretreatment level of agoraphobic complaints, use of psychotropic medication and a longer du ration of the disorder were associated with poorer outcome. Other vari ables, such as the therapeutic relationship and the quality of the mar ital bond, had no prognostic value.