title: The relationships among dyspnoea, health-related quality of life and psychological factors in sarcoidosis.
abstract: OBJECTIVE
  Dyspnoea is a common symptom in sarcoidosis and is not predictably related to pulmonary function or radiology. A subjective symptom of dyspnoea is likely to be influenced by patient perception and experience. The aim of this study was to determine the prevalence and nature of dyspnoea in sarcoidosis and describe the relationship of dyspnoea to psychological factors and health-related quality of life (HRQL).
  
  
  METHODS
  Fifty-six subjects (31 men, mean age 51 years) with sarcoidosis completed an HRQL measure, St George's Respiratory Questionnaire (SGRQ), Hospital Anxiety and Depression Scale (HADS) and Nijmegen questionnaire. The presence of symptoms of dyspnoea was noted and qualitative descriptors for dyspnoea were chosen at peak exercise. Resting pulmonary function was performed.
  
  
  RESULTS
  Sixty-four per cent of the subjects reported dyspnoea. Those with symptoms were older, had a longer duration of disease and with lower forced expiratory volume in 1 s (FEV1 ) and FEV1 /forced vital capacity (FVC) (all P < 0.05). Symptoms of dyspnoea were associated with worse HRQL (P < 0.005) and higher scores on the Nijmegen questionnaire (P < 0.05). Anxiety was not associated with dyspnoea and only a trend to greater depression was observed (P = 0.066). In multivariate analysis, SGRQ and Nijmegen scores predicted dyspnoea independent of demographic factors and resting pulmonary function.
  
  
  CONCLUSIONS
  Dyspnoea is common in sarcoidosis and is associated with worse HRQL irrespective of baseline pulmonary function. Hyperventilation appears to be a factor contributing to dyspnoea and the Nijmegen questionnaire may be helpful in assessing dyspnoea and hyperventilation in sarcoidosis patients.
authors.affiliation: Green Lane Respiratory Services, Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand.
authors.forename: Sally
authors.initials: S
authors.lastname: de Boer
authors.forename: John
authors.initials: J
authors.lastname: Kolbe
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Wilsher
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology; D004417:Dyspnea / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D005541:Forced Expiratory Volume; D006304:Health Status; D006801:Humans; D006985:Hyperventilation / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011653:Pulmonary Diffusing Capacity; D011788:Quality of Life; D017565:Sarcoidosis, Pulmonary / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D014797:Vital Capacity
keywords: depression; dyspnoea; health status; hyperventilation; sarcoidosis