The American Thoracic Society has defined dyspnoea as a
“subjective experience of breathing discomfort that derives from
interactions among multiple physiological, psychological, social,
and environmental factors, which may induce secondary physiological
and behavioural responses”
The
impact of psychological factors on dyspnoea perception in chronic
obstructive pulmonary disease (COPD) has become a topic of
growing interest as the multidimensional nature of dyspnoea has
become more evident
This finding is important
because anxious and depressive symptoms and disorders are
common in COPD, and they increase suffering, morbidity, utilisation
of health services, and even mortality
Once distressed psychological states develop, they may
increase ventilation and worsen perceived dyspnoea to a degree
that is disproportionate to impairment in lung function, so creating
a vicious cycle of increasing disability
Cognitive behaviour therapy (CBT) is an effective treatment for
anxious and depressive symptoms and disorders in the physically
healthy, and there is evidence of its usefulness in patients with
COPD