Perception of induced dyspnea in fibromyalgia and chronic fatigue syndrome
Perception of induced dyspnea in fibromyalgia and chronic fatigue syndrome
复制标题
DOI：
10.1016/j.jpsychores.2018.01.007
复制
发表时间：
2018-03-01
影响因子：
4.7
通讯作者：
Van den Bergh, Omer
中科院分区：
文献类型：
--
作者：
Van Den Houte, Maaike;Bogaerts, Katleen;Van den Bergh, Omer
目的：不明原因呼吸困难患者的呼吸困难感觉是扭曲的。这项研究的目标是：1)在纤维肌痛和/或慢性疲劳综合征(CFS)患者中复制这些结果，2)调查患者组内扭曲症状知觉的预测因素，重点关注负性情感(NA)、精神共病和躯体症状严重程度。方法：73例纤维肌痛和/或CFS患者和38名健康对照(HC)完成了重复呼吸范例，包括基线(60 S室内空气)、再呼吸阶段(150 S，逐渐增加通气量、血液中二氧化碳分压和自我报告的呼吸困难)，和恢复期(房间空气150 S)。结果：恢复期患者的呼吸困难明显多于对照组(p=0.039.0 5)，但在基础状态(p=0.0 7)和复呼吸期(p=0.17)两组间差异无统计学意义。两组患者的生理反应性差异无统计学意义。在患者组内，恢复期的疗效是由躯体症状的严重程度(p=0.046)预测的，而不是由负性情感或精神合并症的数量预测的。结论：这项研究将早期在医学上原因不明的呼吸困难患者的研究结果扩展到纤维肌痛和CFS患者。这表明症状感知的改变是功能性躯体综合征的一种非症状特异性机制，特别是在躯体症状严重程度较高的患者中。这些结果在症状感知的预测编码框架中进行了讨论。
Objective: Dyspnea perception is distorted in patients with medically unexplained dyspnea. The goals of this study were 1) to replicate these results in patients with fibromyalgia and/or chronic fatigue syndrome (CFS), and 2) to investigate predictors of distorted symptom perception within the patient group, with a focus on negative affectivity (NA), psychiatric comorbidity and somatic symptom severity.Methods: Seventy-three patients diagnosed with fibromyalgia and/or CFS and 38 healthy controls (HC) completed a rebreathing paradigm, consisting of a baseline (60 s of room air), a rebreathing phase (150 s, gradually increasing ventilation, partial pressure of CO2 in the blood, and self-reported dyspnea), and a recovery phase (150 s of room air). Dyspnea, respiratory flow and FetCO(2) levels were measured continuously.Results: Patients reported more dyspnea than HC in the recovery phase (p = 0.039), but no differences between patients and HC were found in the baseline (p = 0.07) or rebreathing phase (p = 0.17). No significant differences between patients and HC were found in physiological reactivity. Within the patient group, the effect in the recovery phase was predicted by somatic symptom severity (p = 0.046), but not by negative affectivity or by the number of psychiatric comorbidities.Conclusion: This study extended earlier findings in patients with medically unexplained dyspnea to patients with fibromyalgia and CFS. This suggests that altered symptom perception is a non-symptom-specific mechanism underlying functional somatic syndromes in general, particularly in patients with high levels of somatic symptom severity. The results are discussed in a predictive coding framework of symptom perception.