Dyspnea and symptom amplification in asthma.
BACKGROUND
The severity of a patient's asthma and the intensity with which he describes his dyspnea do not correlate.


OBJECTIVE
There is an indirect relationship between airway function in asthma and the intensity of dyspnea; this relationship is found only when the measure of a patient's general tendency to exaggerate the intensity of any somatic symptom is considered simultaneously.


METHODS
Lung function, including spirometry (forced expiratory volume in 1 s, FEV(1)) and plethysmography (airway resistance, R(aw)), dyspnea (Borg scale score) and the tendency to exaggerate (the somatosensory amplification scale score, SSAS) have been quantified in 42 stable asthmatic patients.


RESULTS
There was no correlation between the Borg score and any spirometric or plethysmographic measure in these subjects. By contrast, there was a moderate correlation between the Borg score and the SSAS (r = 0.36, p = 0.03). However, when FEV(1) or R(aw) (abscissa) and Borg scores (ordinate) were converted to residuals, there was a moderate correlation between the residuals and the SSAS score (for FEV(1), r = 0.33 and p = 0.05; for R(aw), r = -0.36 and p = 0.03).


CONCLUSIONS
A physician may make a reasonable estimate of an asthmatic patient's lung function from the intensity of his complaint only if he - the physician - considers the patient's tendency to symptom amplify as well.
Lavietes
Marc H
MH
Pulmonary/Critical Care Division, Department of Medicine, New Jersey Medical School, Newark, N.J., USA. lavietmh@umdnj.edu
Ameh
Joseph
J
Cherniack
Neil S
NS
D000328:Adult; D001249:Asthma / Q000150:complications / Q000523:psychology*; D001986:Bronchial Spasm / Q000209:etiology / Q000523:psychology*; D004417:Dyspnea / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics / Q000706:statistics & numerical data; D012129:Respiratory Function Tests / Q000706:statistics & numerical data