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 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adolescence is often a time of emotional upheaval and it is no wonder that many respiratory diseases with a psychosomatic component find their origins or time of exacerbation during this time of life. Adolescents who present with unexplained respiratory diseases may also suffer from some form of psychosomatic illness. Recognition of the psychological contributions to symptoms related to the respiratory tract is essential for practitioners who care for adolescents. This article includes some of the more common respiratory or related conditions that have psychological etiologies or components and are encountered in the adolescent patient. These include psychogenic cough, sighing dyspnea, hyperventilation, vocal cord dysfunction, and emotional state as a trigger for asthma. This review provides a general discussion of these conditions and an overview of issues related to psychological/psychiatric evaluation and the reluctance of patients and their parents to access mental health treatment.
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PMID:Respiratory diseases with a psychosomatic component in adolescents. 1106 May 53

The diagnosis of a functional respiratory disorder is sometimes difficult and time-consuming, because the symptoms often resemble those of organic diseases. The most common entities are hyperventilation syndrome, psychogenic cough, sighing dyspnea, and vocal cord dysfunction. Typical signs are heavy breathing or dyspnea, cough or sneezing, various breathing sounds, tightness of the throat or chest, pain, and fear. Criteria for differentiation include the lack of nocturnal symptoms, the sudden occurrence, no typical trigger factors, the variable duration, a quick regression, and that symptoms do not respond to adequate pharmacotherapy and finally normal results of diagnostic work-up. Therapeutic options comprise psychological intervention (by reassurance, relaxation techniques, and behaviour therapy) and physiotherapy (e.g. breathing therapy, voice training). Intensive efforts should be made to diagnose functional symptoms at an early stage because this will prevent stigmatization and fixation of symptoms and disease, and also prevent children from undergoing unnecessary and potentially harmful therapies.
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PMID:Functional symptoms confused with allergic disorders in children and adolescents. 1243 Nov 89

Acute respiratory symptoms often demand immediate medical attention and can be a frightening experience for parents and children alike. Once immediate medical concerns have been dealt with, the physician may be left with a complex clinical picture of uncertain aetiology. Vocal cord dysfunction, hyperventilation, sighing dyspnoea and psychogenic cough are four well-described clinical syndromes where the aetiology may not be clear. Indeed for a busy clinician, it may also be unclear how to manage these patients and when to refer for more detailed psychological or psychiatric management. This paper will discuss the management of complex cases where a range of factors may influence outcome. A framework is presented that can be used to aid formulation and intervention. It is argued that the challenge to the medical practitioner is to combine a medical assessment with careful attention to the personal perceptions and experiences of patients' symptoms. In paediatric and adolescent medicine, particular attention needs to be paid to the wider context of the family, as well as to communication within the consulting room. A clinical example is presented that highlights common dilemmas and illustrates the use of solution-focused brief therapy and motivational interview techniques.
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PMID:Psychological approaches to the management of respiratory symptoms in children and adolescents. 1527 33

The aim of this report is to demonstrate the success of a teamwork approach for providing instruction in self-hypnosis at a Pediatric Pulmonary Center. In order to add to the hypnosis service provided by a pulmonologist at the Center, the Center social worker learned how to use clinical hypnosis. During a 3-year period, she instructed 72 patients (average age 11.6 years) in self-hypnosis. Eighty-two percent of the patients reported improvement or resolution of the primary symptoms, which included anxiety, asthma, chest pain, dyspnea, habit cough, hyperventilation, sighing, and vocal cord dysfunction. The social worker and pulmonologist consulted with each other on a regular basis regarding their hypnosis work, and achieved similar successful results following their hypnosis interventions. Thus, clinical hypnosis at a Pediatric Pulmonary Center can be provided by a team of varied professionals. As a team, these professionals can support each other in their on-going development of hypnosis skills.
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PMID:Teamwork approach to clinical hypnosis at a pediatric pulmonary center. 1623 71

Psychogenic and functional breathing disorders are common and affect mostly children and adolescents, resulting in considerable morbidity and contributing significantly to patient and physician cost and frustration. The most common non-organic clinical entities are psychogenic cough, throat clearing tic, sighing dyspnoea, hyperventilation syndrome, and vocal cord dysfunction. Combinations of organic respiratory diseases and psychogenic aspects can coincide. The mainstay of the diagnosis of psychogenic and functional breathing disorders is full and meticulously taken history. A list of possible questions is presented. Furthermore, the value of a thorough physical examination is often underestimated. If a diagnosis cannot be made clear enough by history taking and examination alone, some baseline instrumental diagnostics are meaningful. An interview with an experienced clinical psychologist and a visit at the physiotherapist may add further information in some cases. Criteria, which differentiate psychogenic or functional breathing symptoms from organic ones, include no nocturnal symptoms, mostly no typical trigger factors, symptoms may occur suddenly and even at rest, speaking is possible without problems and there are normal diagnostic results during episodes of symptoms. Intensive efforts should be made to diagnose psychogenic and functional symptoms, because this will reduce or eliminate harm, prevent stigmatization and fixation of symptoms and disease, allow an untroubled life (including sports), and prevent patients from undergoing unnecessary and potentially harmful therapies.
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PMID:How to diagnose psychogenic and functional breathing disorders in children and adolescents. 2071 25

Somatoform respiratory disorders represent conditions with dysfunctional breathing unexplained by structural abnormalities. This heterogeneous group includes disorders with neural dysregulation of respiration (vocal cord dysfunction) or with dysregulation of the respiratory pattern (hyperventilation, sighing dyspnea), psychogenic disorders such as unjustified anxiety of suffocation, and stereotype conditions such as throat clearing or habit cough. Many symptoms are nonspecific and largely overlap with respiratory disease symptoms of somatic etiology. Most patients will present in a nonspecialized clinical setting. This article provides symptom-based criteria for the definition of somatoform respiratory disorders and their differentiation from somatic disease. Emphasis is put on clinical criteria which can be easily integrated in a routine setting. Owing to the multifaceted etiology of somatoform respiratory disorders therapeutic approaches integrating somatic medicine, respiratory therapy and psychology are crucial. The introduction of defined clinical criteria may facilitate the discrimination of somatoform respiratory disorders from somatic disorders in routine patient encounters and avoid therapeutic detours.
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PMID:Somatoform respiratory disorders in children and adolescents-proposals for a practical approach to definition and classification. 2190 61

Rapid assessment of breathing patterns is important for several emergency medical situations. In this research, we developed a non-invasive breathing analysis system that automatically detects different types of breathing patterns of clinical significance. Accelerometer and gyroscopic data were collected from light-weight wireless sensors placed on the chest and abdomen of 100 normal volunteers who simulated various breathing events (central sleep apnea, coughing, obstructive sleep apnea, sighing, and yawning). We then constructed synthetic datasets by injecting annotated examples of the various patterns into segments of normal breathing. A one-dimensional convolutional neural network was implemented to detect the location of each event in each synthetic dataset and to classify it as belonging to one of the above event types. We achieved a mean F1 score of 92% for normal breathing, 87% for central sleep apnea, 72% for coughing, 51% for obstructive sleep apnea, 57% for sighing, and 63% for yawning. These results demonstrate that using deep learning to analyze chest and abdomen movement data from wearable sensors provides an unobtrusive means of monitoring the breathing pattern. This could have application in a number of critical medical situations such as detecting apneas during sleep at home and monitoring breathing events in mechanically ventilated patients in the intensive care unit.
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PMID:Classification and Detection of Breathing Patterns with Wearable Sensors and Deep Learning. 3320 57

Functional respiratory disorders (FRDs) are those characterized by respiratory symptoms without anatomic or organic etiology. Clinicians caring for children encounter these disorders and should be familiar with diagnosis and treatment. FRDs encompass the habit cough syndrome and its variants, vocal cord dysfunction, hyperventilation disorders, functional dyspnea, and sighing syndrome. Failure to identify these disorders results in unnecessary testing and medication. This article reviews the clinical presentation, manifestation, and treatment of respiratory FRDs in children. How health care providers can successfully identify and treat these reversible conditions in the clinical setting is discussed.
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PMID:Functional Respiratory Disorders in Children. 3322 34


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