What are the subtypes of panic disorder, and how is each managed?

Updated: Mar 21, 2018
  • Author: Mohammed A Memon, MD; Chief Editor: Randon S Welton, MD  more...
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Data from 3 national epidemiologic surveys as well as the Cross-National Collaborative Panic Study suggest the existence of 2 subtypes of panic disorder, respiratory and nonrespiratory. [58] The nonrespiratory subtype was typified by general somatic symptoms, whereas the respiratory subtype was not only thought to be a more severe form of the disorder but also associated with a significantly greater likelihood of lifetime major depression. [58]

Respiratory training can help patients to control hyperventilation during panic attacks and to control anxiety with controlled breathing. In addition, capnometry feedback-assisted breathing training can be used to prevent hypocapnia and stabilize the respiratory rate.

Interoceptive exposure involves encouraging patients to induce internal sensations (e.g., dizziness, increased heart rate, lightheadedness) by spinning, exercising, or rapid breathing and to interpret these as normal bodily sensations. Guided imagery and hypnotic suggestion may also be beneficial.

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