Dyspnea is the highly threatening experience of breathlessness experienced by patients with diverse pathologies, including respiratory, cardiovascular, and neuromuscular diseases, cancer and panic disorder. This debilitating symptom is especially prominent in the elderly and the obese, two growing populations in the Western world. It has further been found that women suffer more strongly from dyspnea than men. Despite optimization of disease-specific treatments, dyspnea is often inadequately treated. The immense burden faced by patients, families and the healthcare system makes improving management of chronic dyspnea a priority. Dyspnea is a multidimensional sensation that encompasses an array of unpleasant respiratory sensations that vary according to underlying cause and patient characteristics. Biopsychological factors beyond disease pathology exacerbate the perception of dyspnea, increase symptom severity and reduce quality of life. Psychological state (especially comorbid anxiety and depression), hormone status, gender, body weight (obesity) and general fitness level are particularly important. Neuroimaging has started to uncover the neural mechanisms involved in the processing of sensory and affective components of dyspnea. Awareness of biopsychological factors beyond pathology is essential for diagnosis and treatment of dyspnea. Increasing understanding the interactions between biopsychological factors and dyspnea perception will enhance the development of symptomatic treatments that specifically address each patient's most pressing needs at a specific stage in life. Future neuroimaging research can provide objective markers to fully understand the role of biopsychological factors in the perception of dyspnea in the hope of uncovering target areas for pharmacologic and non-pharmacologic therapy.

中文翻译：

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将呼吸困难理解为一种复杂的个体体验

呼吸困难是多种疾病患者所经历的呼吸困难的高度威胁体验，包括呼吸系统、心血管和神经肌肉疾病、癌症和恐慌症。这种使人衰弱的症状在老年人和肥胖人群中尤为突出，这两个西方世界不断增长的人群。进一步发现，女性比男性更容易遭受呼吸困难的困扰。尽管针对特定疾病的治疗进行了优化，但呼吸困难往往得不到充分治疗。患者、家庭和医疗保健系统面临的巨大负担使得改善慢性呼吸困难的管理成为当务之急。呼吸困难是一种多维感觉，包括一系列令人不快的呼吸感觉，这些感觉根据根本原因和患者特征而有所不同。疾病病理以外的生物心理因素会加剧呼吸困难的感觉，增加症状的严重程度并降低生活质量。心理状态（尤其是焦虑和抑郁共病）、激素状态、性别、体重（肥胖）和一般健康水平尤为重要。神经影像学已经开始揭示处理呼吸困难的感觉和情感成分所涉及的神经机制。了解病理以外的生物心理因素对于呼吸困难的诊断和治疗至关重要。增加对生物心理因素与呼吸困难感知之间相互作用的了解将促进对症治疗的发展，这些治疗专门针对每个患者在特定生命阶段的最紧迫需求。