A form of behaviour therapy for some states diagnosed as "affective disorder".

Abstract Certain of the states commonly diagnosed by psychiatrists as “affective disorder” do not respond favourably to the usual treatments prescribed, and it is argued by Lum (1976) that such states are not appropriately labelled, as they are primarily due to the somatic condition of hypocapnoea—an abnormally low level of arterial carbon dioxide. This condition is well-recognized and can be diagnosed by appropriate physiological investigation. Hypocapnoea seriously affects various somatic systems, and if the patient later experiences affective distress it is a secondary symptom due to a vicious circle mediated by autonomic responses. The treatment of choice is a form of behaviour therapy aimed at altering the breathing response in the direction of building up toleration of a higher habitual level of arterial carbon dioxide. Existing work by behaviour therapists and others on the physiological and behavioural responses to varying levels of arterial carbon dioxide is cited, and the rationale of symptomatic treatment is discussed. Current treatment methods for hypocapnoea, although behaviourally oriented, are not closely in accord with the principles of modern behaviour therapy, and this paper suggests some directions of improvement.