Department of Psychology, University of Leuven, Leuven, Belgium.
J Abnorm Psychol. 2010 Feb;119(1):226-34. doi: 10.1037/a0017780.
The present study investigated differences in symptom perception between a clinical sample with medically unexplained symptoms (MUS) and a matched healthy control group. Participants (N = 58, 29 patients) were told that they would inhale different gas mixtures that might induce symptoms. Next, they went through 2 subsequent rebreathing trials consisting of a baseline (60 s room air breathing), a rebreathing phase (150 s, which gradually increased ventilation, PCO2 in the blood, and perceived dyspnea), and a recovery phase (150 s, returning to room air breathing). Breathing behavior was continuously monitored, and dyspnea was rated every 10 s. The within-subject correlations between dyspnea on the one hand and end-tidal CO2 and minute ventilation on the other were used to index the degree to which perceived dyspnea was related to specific relevant respiratory changes. The results showed that perceived symptoms were less strongly related to relevant physiological parameters in MUS patients than in healthy persons, specifically when afferent physiological input was relatively weak. This suggests a stronger role for top-down psychological processes in the symptom perception of patients with MUS.
本研究调查了具有医学无法解释症状 (MUS) 的临床样本与匹配的健康对照组之间在症状感知方面的差异。参与者（N=58，29 名患者）被告知他们将吸入不同的混合气体，这些气体可能会引起症状。接下来，他们进行了 2 次随后的重复呼吸试验，包括基线（60 秒室内空气呼吸）、重复呼吸阶段（150 秒，逐渐增加通气、血液中的 PCO2 和感知到的呼吸困难）和恢复阶段（150 秒，恢复到室内空气呼吸）。呼吸行为被连续监测，呼吸困难每 10 秒评定一次。呼吸困难与呼气末二氧化碳和分钟通气量之间的个体内相关性用于指标化感知到的呼吸困难与特定相关呼吸变化的关系程度。结果表明，与健康人相比，MUS 患者的感知症状与相关生理参数的关系较弱，特别是在传入生理输入相对较弱时。这表明在 MUS 患者的症状感知中，自上而下的心理过程起着更强的作用。
