Table 1.

List of studies that have reported the use of various psychological interventions for patients with VCD/PVFM.

Study	Intervention type	Number of participants	Outcome measures	Results
Varney et al. (6)	Case series Low-dose amitriptyline (tricyclic antidepressant) with psychotherapy and behavioral therapies	62 patients (18–90 years) with confirmed diagnosis of VCD	Cessation of symptoms was determined on a return visit by a physician	Cessation of VCD was higher in men (94%) than women (82%), but insomnia improved in all patients
Maturo et al. (16)	Case series with chart review Speech therapy as initial treatment Psychiatric treatment as deemed necessary (biofeedback, hypnosis, and medication management) Empiric medical therapy Surgical intervention	59 children below 18 years-old with PVFM	Treatment-success rate was defined by symptom resolution and/or return to activity	Overall treatment-success rate 76% Speech therapy was 68% successful, while Psychiatric treatment was 100% successful. 12 of the 14 patients treated by psychiatry had major depressive disorder
Richards-Mauze et al. (17)	Case series Cognitive–behavioral intervention	64 children between the ages of 9 and 18 years with VCD; 36 underwent cognitive–behavioral intervention	VCD symptom specific rating scale; Youth Self Report; Children’s Health Locus of Control; Functional Disability Inventory; Child Behavior Check List for parents	Decrease in symptom severity and functional impairment; improved control of breathing and coping with symptoms
Freedman et al. (18)	Retrospective chart review. Each case referred for individual psychotherapy: one refused, one complimented therapy with diazepam	47 women with paradoxical VCD 3 specific cases	Charts studied for signs of childhood sexual abuse or treating clinician was contacted	14 with positive history of sexual abuse, 5 cases with suspected childhood sexual abuse
Anbar (19)	Retrospective chart review Self-hypnosis for treatment of dyspnea that persisted despite medical therapy (1 - month education of self-hypnosis for relaxation and symptom reduction)	22 adolescents (9–17 years)	Patients interested in developing insight into the cause of their dyspnea offered instruction of automatic word processing Symptom improvement was based on evaluation by physician	Symptoms resolved for 18 out of 22 patients within 1 month self-instruction; average duration was 1.8 years
Christopher et al. (5)	Case series Speech therapy and psychotherapy	5 patients with VCD confirmed by laryngoscopy	Reported both by the patient and physician on return visits	Reduced both the number and severity of respiratory attacks in all patients
Selner et al. (20)	Case series Patients with VCD along with concomitant psychological symptoms Referred for long term psychotherapy	3 patients determined to have VCD by pulmonary function tests	Symptom relief determined by attending physician and patient	Full symptom relief in all three cases
Earles et al. (21)	Case report Psychophysiological self-regulation training Commercially available biofeedback equipment was used	2 military service members with VCD confirmed by laryngoscopy	Success of treatment determined by patients	Both patients denied dyspnea and resumed military physical training
Craig et al. (22)	Case report Case 1: referred to speech pathology, ENT, and psychiatry for evaluation. Had post-traumatic stress disorder, underwent psychotherapy Case 2: referred to speech therapy and psychiatry. Evaluation showed anxiety disorder and histrionic personality	2 female military personnel diagnosed with VCD while on active duty	Patient’s reports on state of symptoms	Case 1: Continued to have severe recurrent attacks, though decreased in frequency Case 2: patient refused therapy and remained symptomatic
Warnes et al. (23)	Case report EMG biofeedback training once a week for 10 weeks after breathing exercises had been unsuccessful	One 16-year-old girl with diagnosed 2 year history of PVFM confirmed with laryngoscopic exam	Compare baseline muscle tension to post-treatment muscle tension Subjective reports by patient and patient’s mother	Muscle tension reduced by over 60% Reductions of respiratory distress and chest pain
Thurston et al. (24)	Case report Psychiatry evaluation and speech therapy Cognitive and behavioral-activation techniques	One patient diagnosed with VCD	Improvement of symptoms based on perceptions of patient and attending physician	Symptoms improved based on patient’s perceptions
Corren et al. (25)	Case report Referred to psychology and speech therapy	One 20 year-old woman diagnosed with VCD	Patient’s perception of their VCD symptoms	After several weeks the patient had no symptoms
Anbar et al. (26)	Case report Speech therapy Hypnosis Referred to counseling Use of hypnosis for diagnosis of VCD as well	One 9-year-old boy with symptoms of trouble breathing for four years	Patient’s perception of symptoms	Patient reported that symptoms had subsided almost immediately
Smith et al. (27)	Case report Hypnotherapy Patient was taught self-hypnosis techniques	One 16.5-year-old boy	Respiratory distress and stridor symptoms reported by physician while in hospital and the patient himself	During hypnosis, the stridor decreased 6-month follow-up: patient was asymptomatic and had normal exam
Caraon et al. (28)	Case report Hypnotherapy	One 14-year-old boy with VCD diagnosed by laryngoscopy	Patient’s perception of improvement of symptoms	After the second session of hypnotherapy the patient reported improvement. Asymptomatic at 4-month follow-up
Brown et al. (29)	Case report Patient with history of depression, referred to psychiatric service after a suicide attempt Outpatient psychotherapy and desipramine	One 52-year-old female patient diagnosed with VCD by otolaryngological evaluation	Improvement in symptoms and frequency of episodes	Patient continued therapy with outpatient psychotherapy and desipramine