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Functional respiratory disorders

L Butani1, E J O'Connell

  • 1Section of Pediatric Allergy and Immunology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
|August 1, 1997
PubMed
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Functional respiratory disorders, including paroxysmal sneezing and habit cough, are common in young people and often linked to psychogenic stressors. Treatment should focus on these underlying stressors through a multidisciplinary approach.

Area of Science:

  • Pediatrics
  • Psychiatry
  • Pulmonology

Background:

  • Functional respiratory disorders (FRDs) are prevalent, particularly in children, adolescents, and young adults.
  • These conditions contribute to significant patient and physician burden, including morbidity and frustration.
  • A history of psychiatric disorders and psychogenic stressors is often associated with FRDs.

Purpose of the Study:

  • To enhance healthcare providers' ability to recognize and diagnose FRDs.
  • To provide knowledge on the epidemiology, etiology, clinical features, and treatment of these disorders.
  • To emphasize the importance of identifying and treating underlying psychogenic stressors.

Main Methods:

  • A comprehensive literature review was conducted using MEDLINE.

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  • Searches included terms like "psychogenic wheezing," "vocal cord dysfunction," and "functional respiratory disorders."
  • English language articles from 1966 onward were reviewed, with a focus on human studies evaluating nonorganic respiratory symptoms.

    • Main Results:

    • FRDs are common, affecting primarily younger populations and causing substantial morbidity.
    • Psychogenic stressors and a history of psychiatric conditions are frequently identified in patients with FRDs.
    • While classification is debated (psychosomatic vs. somatoform), consensus exists on treating underlying stressors as the cornerstone of therapy.

    Conclusions:

    • FRDs should be considered in patients with atypical or treatment-resistant respiratory symptoms.
    • Investigating and treating potential psychogenic stressors is crucial.
    • Multidisciplinary management, including reassurance, counseling, and psychiatric intervention, is recommended.