공황 장애와 호흡훈련의 효과: 체계적 문헌고찰 및 메타분석 연구

Abstract

PURPOSE: This systematic review and meta-analysis aimed to investigate the effectiveness of breathing training in patients with panic disorder. METHODS: We acquired 25 comparisons across 9 qualified studies for data synthesis. Individual effect sizes (standardized mean difference; SMD) were estimated by comparing changes in the following physiological and psychological variables between breathing training and control conditions: (a) partial carbon dioxide (pCO2), (b) number of respirations per minute (RR), (c) panic disorder severity scale (PDSS), and (d) anxiety severity index (ASI). RESULTS: The random-effects model meta-analysis showed significant improvements in physiological and psychological variables after breathing training. For physiological variables, increased pCO2 levels (SMD=0.338; standard error [SE]=0.137; 95% confidence interval [CI]=0.070 to 0.607; Z=2.473; p<.013) and decreased RR (SMD=0.342; SE=0.144; 95% CI=0.059 to 0.624; Z=2.372; p<.018) were observed. For psychological variables, breathing training significantly reduced the PDSS (SMD=1.250; SE=0.347; 95% CI=0.570–1.930; Z=3.604; p<.001) and ASI scores (SMD=3.822; SE=1.430; 95% CI=1.019–6.625; Z=2.672; p<.008). CONCLUSIONS: Breathing training is a method with both physiological (pCO2 and RR) and psychological (PDSS and ASI) effectiveness and practicality for patients with panic attacks and panic disorders. Current studies on the application of breathing training as a treatment method to reduce panic disorders and attacks are insufficient. Therefore, future studies should include large-scale, long-term studies that apply breathing training to patients with panic disorders and attacks in Korea.