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Exercise in Panic Disorder: Implications for Disorder Maintenance, Treatment and Physical Health

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Abstract

According to cognitive behavioral models (CBT), panic attacks (PA) arise from distorted and catastrophic interpretations of bodily symptoms. As exercising involves exposure to physiological stimuli similar to those experienced during PAs, patients often experience anxiety and avoid exercising. Exercise avoidance and low levels of everyday physical activity turn out to promote a sedentary lifestyle as an indirect effect of Panic Disorder (PD), with deleterious health impacts. Interoceptive exposure techniques – the voluntary exposure of the patient to autonomic manifestations – have a therapeutic effect in the treatment of panic by promoting habituation to physiological cues contributing to break the hypervigilance-anxiety-panic-avoidance cycle. Preliminary results indicating a potential positive role of aerobic exercise interventions designed to promote interoceptive habituation in the treatment of PD have been reported. The inclusion of an exercise protocol in the context of CBT interventions, may enhance motivation to participate and endure the discomfort and anxiety provoked by exercise using exposure therapy rationale. This chapter reviews and discusses the main results available in the literature of including exercise in the treatment of PD, as well as provides an unique cognitive behavioral perspective to the understanding of the relationship between panic disorder and exercise. We also provide specific recommendations for exercise testing, adherence promotion and particular issues that need to be addresses to successfully include PD patients in exercise protocols, based on authors experience.

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References

  1. Kinley DJ, Cox BJ, Clara I, Goodwin RD, Sareen J. Panic attacks and their relation to psychological and physical functioning in Canadians: results from a nationally representative sample. Can J Psychiatry. 2009;54(2):113–22.

    PubMed  Google Scholar 

  2. Manfro GG, Heldt E, Cordioli AV, Otto MW. Cognitive-behavioral therapy in panic disorder. Rev Bras Psiquiatr. 2008;30 Suppl 2:s81–7.

    Article  PubMed  Google Scholar 

  3. Mitte K. A meta-analysis of the efficacy of psycho- and pharmacotherapy in panic disorder with and without agoraphobia. J Affect Disord. 2005;88(1):27–45.

    Article  PubMed  Google Scholar 

  4. Domschke K, Stevens S, Pfleiderer B, Gerlach AL. Interoceptive sensitivity in anxiety and anxiety disorders: an overview and integration of neurobiological findings. Clin Psychol Rev. 2010;30(1):1–11.

    Article  PubMed  Google Scholar 

  5. Craske MG, Barlow DH, Meadows E. Mastery of your anxiety and panic: therapist guide for anxiety, panic and agoraphobia (MAP-3). San Antonio, TX: Graywind/Psychological Corporation; 2000.

    Google Scholar 

  6. Antony MM, Ledley DR, Liss A, Swinson RP. Responses to symptom induction exercises in panic disorder. Behav Res Ther. 2006;44(1):85–98.

    Article  PubMed  Google Scholar 

  7. Lee K, Noda Y, Nakano Y, Ogawa S, Kinoshita Y, Funayama T, et al. Interoceptive hypersensitivity and interoceptive exposure in patients with panic disorder: specificity and effectiveness. BMC Psychiatry. 2006;6:32.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Broocks A, Bandelow B, Pekrun G, George A, Meyer T, Bartmann U, et al. Comparison of aerobic exercise, clomipramine, and placebo in the treatment of panic disorder. Am J Psychiatry. 1998;155(5):603–9.

    Article  CAS  PubMed  Google Scholar 

  9. Merom D, Phongsavan P, Wagner R, Chey T, Marnane C, Steel Z, et al. Promoting walking as an adjunct intervention to group cognitive behavioral therapy for anxiety disorders—a pilot group randomized trial. J Anxiety Disord. 2008;22(6):959–68.

    Article  PubMed  Google Scholar 

  10. Wedekind D, Broocks A, Weiss N, Engel K, Neubert K, Bandelow B. A randomized, controlled trial of aerobic exercise in combination with paroxetine in the treatment of panic disorder. World J Biol Psychiatry. 2010;11(7):904–13.

    Article  PubMed  Google Scholar 

  11. Strohle A, Feller C, Onken M, Godemann F, Heinz A, Dimeo F. The acute antipanic activity of aerobic exercise. Am J Psychiatry. 2005;162(12):2376–8.

    Article  PubMed  Google Scholar 

  12. Sardinha A, Araujo CGS, Soares-Filho GL, Nardi AE. Anxiety, panic disorder and coronary artery disease: issues concerning physical exercise and cognitive behavioral therapy. Expert Rev Cardiovasc Ther. 2011;9(2):165–75.

    Article  CAS  PubMed  Google Scholar 

  13. Broman-Fulks JJ, Storey KM. Evaluation of a brief aerobic exercise intervention for high anxiety sensitivity. Anxiety Stress Coping. 2008;21(2):117–28.

    Article  PubMed  Google Scholar 

  14. McNally RJ. Anxiety sensitivity and panic disorder. Biol Psychiatry. 2002;52(10):938–46.

    Article  PubMed  Google Scholar 

  15. Hayward C, Wilson KA. Anxiety sensitivity: a missing piece to the agoraphobia-without-panic puzzle. Behav Modif. 2007;31(2):162–73.

    Article  PubMed  Google Scholar 

  16. Story TJ, Craske MG. Responses to false physiological feedback in individuals with panic attacks and elevated anxiety sensitivity. Behav Res Ther. 2008;46(9):1001–8.

    Article  PubMed  Google Scholar 

  17. Sardinha A, Nardi AE, Zin WA. Are panic attacks really harmless? The cardiovascular impact of panic disorder. Rev Bras Psiquiatr. 2009;31(1):57–62.

    Article  PubMed  Google Scholar 

  18. Phongsavan P, Merom D, Wagner R, Chey T, von Hofe B, Silove D, et al. Process evaluation in an intervention designed to promote physical activity among adults with anxiety disorders: evidence of acceptability and adherence. Health Promot J Austr. 2008;19(2):137–43.

    PubMed  Google Scholar 

  19. Schmidt NB, Lerew DR, Santiago H, Trakowski JH, Staab JP. Effects of heart-rate feedback on estimated cardiovascular fitness in patients with panic disorder. Depress Anxiety. 2000;12(2):59–66.

    Article  CAS  PubMed  Google Scholar 

  20. Broocks A, Meyer TF, Bandelow B, George A, Bartmann U, Ruther E, et al. Exercise avoidance and impaired endurance capacity in patients with panic disorder. Neuropsychobiology. 1997;36(4):182–7.

    Article  CAS  PubMed  Google Scholar 

  21. Sardinha A, Nardi AE, Araujo CGS, Ferreira MC, Eifert GH. Brazilian Portuguese validated version of the cardiac anxiety questionnaire. Arq Bras Cardiol. 2013;101(6):554–61.

    PubMed  PubMed Central  Google Scholar 

  22. Zvolensky MJ, Feldner MT, Eifert GH, Vujanovic AA, Solomon SE. Cardiophobia: a critical analysis. Transcult Psychiatry. 2008;45(2):230–52.

    Article  PubMed  Google Scholar 

  23. Barsky AJ. Palpitations, arrhythmias, and awareness of cardiac activity. Ann Intern Med. 2001;134(9 Pt 2):832–7.

    Article  CAS  PubMed  Google Scholar 

  24. Eley TC, Stirling L, Ehlers A, Gregory AM, Clark DM. Heart-beat perception, panic/somatic symptoms and anxiety sensitivity in children. Behav Res Ther. 2004;42(4):439–48.

    Article  PubMed  Google Scholar 

  25. Ehlers A, Mayou RA, Sprigings DC, Birkhead J. Psychological and perceptual factors associated with arrhythmias and benign palpitations. Psychosom Med. 2000;62(5):693–702.

    Article  CAS  PubMed  Google Scholar 

  26. Eifert GH, Thompson RN, Zvolensky MJ, Edwards K, Frazer NL, Haddad JW, et al. The cardiac anxiety questionnaire: development and preliminary validity. Behav Res Ther. 2000;38(10):1039–53.

    Article  CAS  PubMed  Google Scholar 

  27. Mueller PJ. Exercise training and sympathetic nervous system activity: evidence for physical activity dependent neural plasticity. Clin Exp Pharmacol Physiol. 2007;34(4):377–84.

    Article  CAS  PubMed  Google Scholar 

  28. Smits JA, Zvolensky MJ. Emotional vulnerability as a function of physical activity among individuals with panic disorder. Depress Anxiety. 2006;23(2):102–6.

    Article  PubMed  Google Scholar 

  29. Sardinha A, Araujo CGS, Nardi AE. Psychiatric disorders and cardiac anxiety in exercising and sedentary coronary artery disease patients: a case-control study. Braz J Med Biol Res. 2012;45(12):1320–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Frasure-Smith N, Lesperance F. Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease. Arch Gen Psychiatry. 2008;65(1):62–71.

    Article  CAS  PubMed  Google Scholar 

  31. Alberti KG, Zimmet P, Shaw J. The metabolic syndrome—a new worldwide definition. Lancet. 2005;366(9491):1059–62.

    Article  PubMed  Google Scholar 

  32. Fleet R, Lesperance F, Arsenault A, Gregoire J, Lavoie K, Laurin C, et al. Myocardial perfusion study of panic attacks in patients with coronary artery disease. Am J Cardiol. 2005;96(8):1064–8.

    Article  PubMed  Google Scholar 

  33. Marshall EC, Zvolensky MJ, Sachs-Ericsson N, Schmidt NB, Bernstein A. Panic attacks and physical health problems in a representative sample: singular and interactive associations with psychological problems, and interpersonal and physical disability. J Anxiety Disord. 2008;22(1):78–87.

    Article  PubMed  Google Scholar 

  34. de Wit LM, Fokkema M, van Straten A, Lamers F, Cuijpers P, Penninx BW. Depressive and anxiety disorders and the association with obesity, physical, and social activities. Depress Anxiety. 2010;27(11):1057–65.

    Article  PubMed  Google Scholar 

  35. Meyer T, Broocks A, Bandelow B, Hillmer-Vogel U, Ruther E. Endurance training in panic patients: spiroergometric and clinical effects. Int J Sports Med. 1998;19(7):496–502.

    Article  CAS  PubMed  Google Scholar 

  36. Lollgen H, Bockenhoff A, Knapp G. Physical activity and all-cause mortality: an updated meta-analysis with different intensity categories. Int J Sports Med. 2009;30(3):213–24.

    Article  CAS  PubMed  Google Scholar 

  37. Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA. 2009;301(19):2024–35.

    Article  CAS  PubMed  Google Scholar 

  38. Chen YH, Tsai SY, Lee HC, Lin HC. Increased risk of acute myocardial infarction for patients with panic disorder: a nationwide population-based study. Psychosom Med. 2009;71(7):798–804.

    Article  PubMed  Google Scholar 

  39. Walters K, Rait G, Petersen I, Williams R, Nazareth I. Panic disorder and risk of new onset coronary heart disease, acute myocardial infarction, and cardiac mortality: cohort study using the general practice research database. Eur Heart J. 2008;29(24):2981–8.

    Article  PubMed  Google Scholar 

  40. Sardinha A, Nardi AE. The role of anxiety in metabolic syndrome. Expert Rev Endocrinol Metab. 2012;7(1):63–71.

    Article  Google Scholar 

  41. Fleet R, Foldes-Busque G, Gregoire J, Harel F, Laurin C, Burelle D, et al. A study of myocardial perfusion in patients with panic disorder and low risk coronary artery disease after 35 % CO2 challenge. J Psychosom Res. 2014;76(1):41–5.

    Article  PubMed  Google Scholar 

  42. Epel ES. Psychological and metabolic stress: a recipe for accelerated cellular aging? Hormones (Athens). 2009;8(1):7–22.

    Article  Google Scholar 

  43. Bjorntorp P. Do stress reactions cause abdominal obesity and comorbidities? Obes Rev. 2001;2(2):73–86.

    Article  CAS  PubMed  Google Scholar 

  44. Tamashiro KL, Hegeman MA, Sakai RR. Chronic social stress in a changing dietary environment. Physiol Behav. 2006;89(4):536–42.

    Article  CAS  PubMed  Google Scholar 

  45. Kassi E, Pervanidou P, Kaltsas G, Chrousos G. Metabolic syndrome: definitions and controversies. BMC Med. 2011;9:48.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Smits JA, Rosenfield D, Mather AA, Tart CD, Henriksen C, Sareen J. Psychotropic medication use mediates the relationship between mood and anxiety disorders and obesity: findings from a nationally representative sample. J Psychiatr Res. 2010;44(15):1010–6.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Ramos PS, Sardinha A, Nardi AE, Araujo CGS. Cardiorespiratory optimal point: a submaximal exercise variable to assess panic disorder patients. PLoS One. 2014;9(8):e104932.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Belem da Silva CT, Schuch F, Costa M, Hirakata V, Manfro GG. Somatic, but not cognitive, symptoms of anxiety predict lower levels of physical activity in panic disorder patients. J Affect Disord. 2014;164:63–8.

    Article  PubMed  Google Scholar 

  49. Muotri RW, Bernik MA. Panic disorder and exercise avoidance. Rev Bras Psiquiatr. 2014;36:68–75.

    Article  PubMed  Google Scholar 

  50. Pollard CA. Respiratory distress during panic attacks associated with agoraphobia. Psychol Rep. 1986;58(1):61–2.

    Article  CAS  PubMed  Google Scholar 

  51. Soares-Filho GL, Arias-Carrion O, Santulli G, Silva AC, Machado S, Valenca AM, et al. Chest pain, panic disorder and coronary artery disease: a systematic review. CNS Neurol Disord Drugs Targets. 2014;13(6):992–1001.

    Article  CAS  Google Scholar 

  52. Hung RK, Al-Mallah MH, McEvoy JW, Whelton SP, Blumenthal RS, Nasir K, et al. Prognostic value of exercise capacity in patients with coronary artery disease: the FIT (Henry Ford ExercIse Testing) project. Mayo Clinic Proc. 2014;89(12):1644–54.

    Article  Google Scholar 

  53. Kokkinos P, Myers J, Faselis C, Panagiotakos DB, Doumas M, Pittaras A, et al. Exercise capacity and mortality in older men: a 20-year follow-up study. Circulation. 2010;122(8):790–7.

    Article  PubMed  Google Scholar 

  54. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002;346(11):793–801.

    Article  PubMed  Google Scholar 

  55. Farrell SW, Finley CE, Haskell WL, Grundy SM. Is there a gradient of mortality risk among men with low cardiorespiratory fitness? Med Sci Sports Exerc. 2014 (online first).

    Google Scholar 

  56. Gomes RM, Sardinha A, Araújo CGS, Nardi AE, Deslandes AC. Aerobic training intervention in panic disorder: a case-series study. Med Express. 2014;1(4):195–201.

    Article  Google Scholar 

  57. Sardinha A, Araújo CGS, Nardi AE. Interval aerobic training as a tool in the cognitive-behavioral treatment of panic disorder. J Bras Psiquiatr. 2011;60(3):227–30.

    Article  Google Scholar 

  58. American Thoracic S, American College of Chest P. ATS/ACCP Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2003;167(2):211–77.

    Article  Google Scholar 

  59. Araújo CGS. Teste cardiopulmonar de exercício: breves considerações sobre passado, presente e futuro. Rev DERC. 2012;18(4):104.

    Google Scholar 

  60. Balady GJ, Arena R, Sietsema K, Myers J, Coke L, Fletcher GF, et al. Clinician’s guide to cardiopulmonary exercise testing in adults: a scientific statement from the American Heart Association. Circulation. 2010;122(2):191–225.

    Article  PubMed  Google Scholar 

  61. Guazzi M, Adams V, Conraads V, Halle M, Mezzani A, Vanhees L, et al. EACPR/AHA Joint Scientific Statement. Clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations. Eur Heart J. 2012;33(23):2917–27.

    Article  PubMed  Google Scholar 

  62. Araújo CGS, Herdy AH, Stein R. Maximum oxygen consumption measurement: valuable biological marker in health and in sickness. Arq Bras Cardiol. 2013;100(4):e51–3.

    PubMed  Google Scholar 

  63. Ricardo DR, De Almeida MB, Franklin BA, Araújo CGS. Initial and final exercise heart rate transients: Influence of gender, aerobic fitness, and clinical status. Chest. 2005;127(1):318–27.

    Article  PubMed  Google Scholar 

  64. Ramos PS, Araújo CG. Análise da estabilidade de variável submáxima em teste cardiopulmonar de exercício: ponto ótimo cardiorrespiratório. Rev Bras Ativ Fis Saúde. 2013;18(5):585–93.

    Article  Google Scholar 

  65. Ramos PS, Ricardo DR, Araujo CG. Cardiorespiratory optimal point: a submaximal variable of the cardiopulmonary exercise testing. Arq Bras Cardiol. 2012;99(5):988–96.

    Article  PubMed  Google Scholar 

  66. Kruk J. Physical activity in the prevention of the most frequent chronic diseases: an analysis of the recent evidence. Asian Pac J Cancer Prev. 2007;8(3):325–38.

    PubMed  Google Scholar 

  67. Subirats Bayego E, Subirats Vila G, Soteras Martinez I. Exercise prescription: indications, dosage and side effects. Med Clin (Barc). 2012;138(1):18–24.

    Article  Google Scholar 

  68. Strohle A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm. 2009;116(6):777–84.

    Article  PubMed  Google Scholar 

  69. Zschucke E, Gaudlitz K, Strohle A. Exercise and physical activity in mental disorders: clinical and experimental evidence. J Prev Med Public Health. 2013;46 Suppl 1:S12–21.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Teachman BA, Marker CD, Clerkin EM. Catastrophic misinterpretations as a predictor of symptom change during treatment for panic disorder. J Consult Clin Psychol. 2010;78(6):964–73.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Gary RA, Dunbar SB, Higgins MK, Musselman DL, Smith AL. Combined exercise and cognitive behavioral therapy improves outcomes in patients with heart failure. J Psychosom Res. 2010;69(2):119–31.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Asmundson GJ, Fetzner MG, Deboer LB, Powers MB, Otto MW, Smits JA. Let’s get physical: a contemporary review of the anxiolytic effects of exercise for anxiety and its disorders. Depress Anxiety. 2013;30(4):362–73.

    Article  PubMed  Google Scholar 

  73. Faulkner J, Westrupp N, Rousseau J, Lark S. A randomized controlled trial to assess the effect of self-paced walking on task-specific anxiety in cardiac rehabilitation patients. J Cardiopulm Rehabil Prev. 2013;33(5):292–6.

    Article  PubMed  Google Scholar 

  74. Smits JA, Meuret AE, Zvolensky MJ, Rosenfield D, Seidel A. The effects of acute exercise on CO(2) challenge reactivity. J Psychiatr Res. 2009;43(4):446–54.

    Article  PubMed  Google Scholar 

  75. Esquivel G, Schruers K, Kuipers H, Griez E. The effects of acute exercise and high lactate levels on 35 % CO2 challenge in healthy volunteers. Acta Psychiatr Scand. 2002;106(5):394–7.

    Article  CAS  PubMed  Google Scholar 

  76. Esquivel G, Diaz-Galvis J, Schruers K, Berlanga C, Lara-Munoz C, Griez E. Acute exercise reduces the effects of a 35 % CO2 challenge in patients with panic disorder. J Affect Disord. 2008;107(1–3):217–20.

    Article  PubMed  Google Scholar 

  77. Strohle A, Stoy M, Graetz B, Scheel M, Wittmann A, Gallinat J, et al. Acute exercise ameliorates reduced brain-derived neurotrophic factor in patients with panic disorder. Psychoneuroendocrinology. 2010;35(3):364–8.

    Article  PubMed  Google Scholar 

  78. Strohle A, Feller C, Strasburger CJ, Heinz A, Dimeo F. Anxiety modulation by the heart? Aerobic exercise and atrial natriuretic peptide. Psychoneuroendocrinology. 2006;31(9):1127–30.

    Article  PubMed  Google Scholar 

  79. Kornreich C. Panic, somatization and exercise. Rev Med Brux. 2006;27(2):78–82.

    CAS  PubMed  Google Scholar 

  80. Broocks A, Meyer T, Opitz M, Bartmann U, Hillmer-Vogel U, George A, et al. 5-HT1A responsivity in patients with panic disorder before and after treatment with aerobic exercise, clomipramine or placebo. Eur Neuropsychopharmacol. 2003;13(3):153–64.

    Article  CAS  PubMed  Google Scholar 

  81. Broocks A, Meyer T, Gleiter CH, Hillmer-Vogel U, George A, Bartmann U, et al. Effect of aerobic exercise on behavioral and neuroendocrine responses to meta-chlorophenylpiperazine and to ipsapirone in untrained healthy subjects. Psychopharmacology (Berl). 2001;155(3):234–41.

    Article  CAS  Google Scholar 

  82. Wedekind D, Sprute A, Broocks A, Huther G, Engel K, Falkai P, et al. Nocturnal urinary cortisol excretion over a randomized controlled trial with paroxetine vs. placebo combined with relaxation training or aerobic exercise in panic disorder. Curr Pharm Des. 2008;14(33):3518–24.

    Article  CAS  PubMed  Google Scholar 

  83. Hovland A, Nordhus IH, Sjobo T, Gjestad BA, Birknes B, Martinsen EW, et al. Comparing physical exercise in groups to group cognitive behaviour therapy for the treatment of panic disorder in a randomized controlled trial. Behav Cogn Psychother. 2013;41(4):408–32.

    Article  PubMed  Google Scholar 

  84. Broman-Fulks JJ, Berman ME, Rabian BA, Webster MJ. Effects of aerobic exercise on anxiety sensitivity. Behav Res Ther. 2004;42(2):125–36.

    Article  PubMed  Google Scholar 

  85. Keough ME, Schmidt NB. Refinement of a brief anxiety sensitivity reduction intervention. J Consult Clin Psychol. 2012;80(5):766–72.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Smits JA, Berry AC, Rosenfield D, Powers MB, Behar E, Otto MW. Reducing anxiety sensitivity with exercise. Depress Anxiety. 2008;25(8):689–99.

    Article  PubMed  Google Scholar 

  87. Jayakody K, Gunadasa S, Hosker C. Exercise for anxiety disorders: systematic review. Br J Sports Med. 2014;48(3):187–96.

    Article  PubMed  Google Scholar 

  88. Bartley CA, Hay M, Bloch MH. Meta-analysis: aerobic exercise for the treatment of anxiety disorders. Prog Neuropsychopharmacol Biol Psychiatry. 2013;45:34–9.

    Article  PubMed  Google Scholar 

  89. Taylor S, Cox BJ. An expanded anxiety sensitivity index: evidence for a hierarchic structure in a clinical sample. J Anxiety Disord. 1998;12(5):463–83.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Aline Sardinha

  2. Cognitive Therapy Association of Rio de Janeiro (ATC-Rio), Rio de Janeiro, Brazil

    Aline Sardinha

  3. Heart Institute Edson Saad, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Claudio Gil Soares de Araújo

  4. Exercise Medicine Clinic (CLINIMEX), Rio de Janeiro, Brazil

    Claudio Gil Soares de Araújo

Authors
  1. Aline Sardinha
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  2. Claudio Gil Soares de Araújo
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Correspondence to Aline Sardinha .

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Editors and Affiliations

  1. Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Antonio Egidio Nardi

  2. Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Rafael Christophe R. Freire

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Sardinha, A., de Araújo, C.G.S. (2016). Exercise in Panic Disorder: Implications for Disorder Maintenance, Treatment and Physical Health. In: Nardi, A., Freire, R. (eds) Panic Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-12538-1_18

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