Treat the lungs, fool the brain and appease the mind: towards holistic care of patients who suffer from chronic respiratory diseases

The Impact of Unpredictability on Dyspnea Perception, Anxiety and Interoceptive Error Processing

“…The current results are in line with previous findings from qualitative studies which demonstrated that the unpredictability of dyspnea is particularly frightening for patients with cardiopulmonary diseases or cancer and amplifies their perception of dyspnea (Booth et al, 2018; Lovell et al, 2018; Linde et al, 2018). These findings also converge with previous notions that the perception of dyspnea is a subjective interpretation process of respiratory input that is strongly modulated by multiple factors (von Leupoldt and Dahme, 2007; Lansing et al, 2009; Janssens et al, 2011; Hayen et al, 2013; Herigstad et al, 2017; Spathis et al, 2017; Van den Bergh et al, 2017; von Leupoldt, 2017; Similowski, 2018). For example, one model describes that the perception of dyspnea consists of a sensory component (intensity) and an affective component (unpleasantness) (Wilson and Jones, 1991; Meek et al, 2003; von Leupoldt and Dahme, 2005; Lansing et al, 2009).…”

“…Recent research has suggested that the perception of dyspnea is a complex individual interpretation process of respiratory input that is modulated by affective and cognitive factors (Lansing et al, 2009; Janssens et al, 2011; Hayen et al, 2013; Herigstad et al, 2017; Spathis et al, 2017; Van den Bergh et al, 2017; von Leupoldt, 2017; Similowski, 2018). For example, previous studies have demonstrated that high levels of state and trait anxiety are associated with elevated reports of dyspnea in everyday-life settings (Xu et al, 2008) as well as in experimental studies in healthy individuals (Alius et al, 2013; Stoeckel et al, 2015; Sharma et al, 2016; Herzog et al, 2018) and patients with cardiopulmonary diseases (Livermore et al, 2008; Reijnders et al, 2019; von Leupoldt et al, 2011).…”

ERS Scientific Working Group 09.04, “Psychologists and behavioural scientists”: the next step towards multidisciplinary respiratory care

“…Alongside the "classical" medical and therapeutic components, support preferably involves further important elements, such as guided self-management, psychosocial interventions and behaviour change techniques, supported by a multidisciplinary team [2,9,12,[17][18][19]. However, psychosocial and behavioural factors are still considerably under-recognised in chronic respiratory care and research, thus limiting the availability of comprehensive, integrated and holistic treatments and preventing optimal treatment effects [4,11,20]. Therefore, the new ERS scientific working group 09.04 is of great added value from a clinical, scientific and educational perspective.…”

Lessons from negative dyspnoea studies: arguments for the multidimensional evaluation of multidirectional therapeutic approaches

“…Finally, one should remember that when neither the lung nor the brain are accessible to dyspnoea-relieving interventions, coping approaches can have a positive effect and "appease the mind" [28]: COPD patients have demonstrated significant and sustained benefits from mindfulness-based cognitive therapy, even in the absence of dyspnoea improvement [29]. In other words, an intervention that does not relieve dyspnoea can however be beneficial to the well-being of dyspnoeic patients.…”