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Objective: Patients seeking treatment for their asthma are most likely motivated by a change in their experience of symptoms, but primary complaints are not always related to the pulmonary system. This study aimed to determine the frequency of such extrapulmonary symptoms in asthma outpatients and their association with psychopathology and asthma outcomes., Methods: This cross-sectional study utilized data collected as part of a nationwide, clinical-epidemiological study. The final sample of 572 asthma patients represented all levels of asthma control and severity. Information on demographics and respiratory function was obtained from physicians' documentation. Symptoms were explored using a standardized checklist., Results: Primary symptoms reported by asthma patients were not necessarily airway-related. Patients reported feeling at least occasionally "tired" (72.1%) and "exhausted" (66.8%) more than any other asthma symptom. Hyperventilation and mood symptoms were experienced by 34.4-42.6% of patients. Anxiety or depression diagnoses indicated higher scores in all symptom domains. Controlling for asthma-related factors and psychopathology, fatigue had a small but significant effect on both asthma-related quality of life (AQLQ) (r sp 2  = 0.02, P < .001) and asthma control (r sp 2  = 0.01, P = .003). Mood symptoms also showed a small but significant effect on AQLQ (r sp 2  = 0.02, P < .001)., Conclusion: Findings suggest that extrapulmonary symptoms are endorsed more frequently than previously reported. Symptoms nonspecific to asthma can play a substantial role in clinical presentation and exclusive focus on airway symptoms may miss important information related to patients' well-being. Surveillance of extrapulmonary symptoms alongside pulmonary function is warranted for an integrated medicine approach to asthma management., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objective: Previous asthma diary studies have yielded equivocal findings on concurrent associations between lung function and mood, and prospective associations have rarely been explored. We therefore examined concurrent and prospective associations between daily mood, shortness of breath, and lung function, and studied between-individual variability and stability of concurrent associations across different times of the day., Method: Twenty asthma patients and 20 healthy controls recorded their positive and negative mood, shortness of breath, physical activity, peak expiratory flow (PEF) and forced expiratory volume in the first second (FEV(1)) using an electronic pocket spirometer with diary functions three times per day for about 21 days., Results: For both groups, PEF showed positive concurrent associations with ratings of various mood states, whereas FEV(1) was only associated with positive mood. Both indices correlated negatively with shortness of breath. Within-individual concurrent associations varied significantly in both groups and their stability varied across time of the day, with overall higher stability for associations with shortness of breath in asthma and PEF for both groups. Prospectively, higher shortness of breath consistently predicted lower lung function later during the day and on the subsequent day., Conclusion: The relationship between normal mood variations and lung function is highly variable across individuals and times of the day, limiting the predictive value of average group associations. Shortness of breath is predictive of future lung function decline in asthma. Future longitudinal research should focus on extreme emotional states, effort-independent measures of lung function, and additional indicators of asthma control., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Objective: It has been observed that spontaneous swallowing rates are modulated by the affective state. Affect-induced swallowing may be an important biobehavioral factor in gastrointestinal disorders. However, previous studies failed to distinguish between pleasantness and arousal effects and did not analyze gender effects., Method: We analyzed swallowing rates in 42 participants (22 women) who viewed 3 blocks of 12 affective pictures preselected for inducing positive, negative, and neutral affect. Swallowing rate was measured by brief and rapid resistance increases in forced oscillation measurements indicating closure of the glottis. In addition, participants rated pleasantness and arousal for each individual picture., Results: Cumulative swallowing rates were lower during positive and neutral than negative picture blocks. This effect was only observed in women. Ratings confirmed earlier findings with picture material., Conclusion: Both pleasantness and arousal interact to modulate swallowing rates. The role of gender in moderating affect-induced swallowing requires further research.

Objectives: Biofeedback techniques have long been recommended as an adjunctive treatment for bronchial asthma. Techniques that target lung function directly, or indirectly by altering facial muscle tension, heart rate, heart rate variability (HRV) or inspiratory volume together with accessory muscle tension, have been proposed. We review evidence for the effectiveness of these biofeedback interventions and discuss the psychophysiological rationale behind individual techniques., Method: Controlled studies of biofeedback in asthma were retrieved using relevant search engines and reference lists of published articles. Effect sizes comparing intervention with control groups were calculated where appropriate., Results: Most of the studies suffer from methodological inadequacies or poor reporting of methods and results. Interventions targeting respiratory resistance directly have yielded only small and inconsistent changes in lung function and are difficult to implement without producing dynamic hyperinflation. Biofeedback-assisted facial muscle relaxation as an indirect intervention has yielded mixed results across studies, with only half of the studies showing significant albeit very small and clinically irrelevant improvements in lung function. The underlying physiological assumptions of the technique are questionable in the light of current knowledge of respiratory physiology. For other indirect techniques, only preliminary evidence of small effects is available., Conclusion: Currently, there is little good evidence that biofeedback techniques can contribute substantially to the treatment of asthma., (Copyright 2004 Elsevier Inc.)