Acquired sensitivity to relevant physiological activity in patients with chronic health problems

The hypothesis that biased symptom perception toward excessive symptoms is common when relatively normal chronic patients enter symptom-relating situations, irrespective of emotional variables, was tested in 19 women with severe asthma, 18 with somatization-like characteristics, and 18 controls. Each underwent three experimental conditions: mental stress, resting, and physical exercise. Each condition included three breathing conditions: breathing normally, normal compressed air, and 5.5% CO2-enriched compressed air. Results yielded no group differences in physiological measures, e.g. elevated CO2 in exhaled air (end-tidal partial pressure of CO2, PetCO(2)), or lung function. Asthma patients experienced more breathlessness, and somatization-like participants more breathlessness, miscellaneous symptoms, and subjective stress than controls. Although these differences suggested acquired biased symptom perception, as it turned out, breathlessness in asthmatics was more influenced by PetCO(2) and less by subjective stress compared to controls. Likewise, breathlessness in somatization-like participants was similarly influenced by PetCO(2) and subjective stress compared to controls, and miscellaneous symptoms were even more influenced by PetCO(2) and less by subjective stress compared to controls. It was concluded that acquired sensitivity to physiological activity associated with habitual symptoms may account for excessive symptoms in patients with chronic health problems. (C) 2003 Elsevier Ltd. All rights reserved.