Sex-differences in the multidimensional evaluation of dyspnea in respiratory outpatients

BackgroundFemales experience greater dyspnea intensity compared to males. The role of sex in dyspnea quality and emotional responses in respiratory outpatients is unknown. The aim of this study was to examine sex-differences in dyspnea quality and affective distress as well as relationships between...

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Main Authors: Kathryn M. Milne, Julia Zhang, Owen D. Harris, Jordan A. Guenette
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1627496/full
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author Kathryn M. Milne
Kathryn M. Milne
Kathryn M. Milne
Julia Zhang
Owen D. Harris
Jordan A. Guenette
Jordan A. Guenette
Jordan A. Guenette
author_facet Kathryn M. Milne
Kathryn M. Milne
Kathryn M. Milne
Julia Zhang
Owen D. Harris
Jordan A. Guenette
Jordan A. Guenette
Jordan A. Guenette
author_sort Kathryn M. Milne
collection DOAJ
description BackgroundFemales experience greater dyspnea intensity compared to males. The role of sex in dyspnea quality and emotional responses in respiratory outpatients is unknown. The aim of this study was to examine sex-differences in dyspnea quality and affective distress as well as relationships between dyspnea, anxiety, and depression.Materials and methodsRespiratory outpatients rated chronic exertional dyspnea intensity and impact using the modified Medical Research Council (mMRC) dyspnea scale. Participants selected qualitative dyspnea descriptors from an established list of 15 descriptors and completed the Multidimensional Dyspnea Profile (MDP). Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS).ResultsParticipants (n = 78) had a variety of common respiratory diagnoses. Males and females experienced similar dyspnea impact (mMRC) and were matched for relative impairment in lung function. Females rated higher intensity of breathing muscle work, chest tightness, and mental effort. The affective response to dyspnea was greater in females, with significantly higher reports of anxiety, frustration, and fear related to dyspnea. HADS anxiety subscale scores were correlated with MDP dyspnea scores of breathing discomfort, immediate perception domain, and emotional response domain in males. In females, higher HADS anxiety scores were correlated with the emotional response domain only. Males with higher likelihood of anxiety experienced greater frustration, anger, and fear related to dyspnea; however, this was not the case for females.ConclusionIn respiratory outpatients, despite similar lung function impairment and mMRC scores, females experience greater breathing muscle work, chest tightness, and mental effort as well as significantly greater anxiety, frustration, and fear related to dyspnea.
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spelling doaj-art-69bf5da76a3a4cca8dcc73e1dcae88882025-08-20T02:36:07ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.16274961627496Sex-differences in the multidimensional evaluation of dyspnea in respiratory outpatientsKathryn M. Milne0Kathryn M. Milne1Kathryn M. Milne2Julia Zhang3Owen D. Harris4Jordan A. Guenette5Jordan A. Guenette6Jordan A. Guenette7Centre for Heart Lung Innovation, St. Paul’s Hospital, The University of British Columbia and Providence Research, Vancouver, BC, CanadaDivision of Respiratory Medicine, The University of British Columbia, Vancouver, BC, CanadaCentre for Lung Health, The University of British Columbia, Vancouver, BC, CanadaCentre for Heart Lung Innovation, St. Paul’s Hospital, The University of British Columbia and Providence Research, Vancouver, BC, CanadaCentre for Heart Lung Innovation, St. Paul’s Hospital, The University of British Columbia and Providence Research, Vancouver, BC, CanadaCentre for Heart Lung Innovation, St. Paul’s Hospital, The University of British Columbia and Providence Research, Vancouver, BC, CanadaDivision of Respiratory Medicine, The University of British Columbia, Vancouver, BC, CanadaDepartment of Physical Therapy, The University of British Columbia, Vancouver, BC, CanadaBackgroundFemales experience greater dyspnea intensity compared to males. The role of sex in dyspnea quality and emotional responses in respiratory outpatients is unknown. The aim of this study was to examine sex-differences in dyspnea quality and affective distress as well as relationships between dyspnea, anxiety, and depression.Materials and methodsRespiratory outpatients rated chronic exertional dyspnea intensity and impact using the modified Medical Research Council (mMRC) dyspnea scale. Participants selected qualitative dyspnea descriptors from an established list of 15 descriptors and completed the Multidimensional Dyspnea Profile (MDP). Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS).ResultsParticipants (n = 78) had a variety of common respiratory diagnoses. Males and females experienced similar dyspnea impact (mMRC) and were matched for relative impairment in lung function. Females rated higher intensity of breathing muscle work, chest tightness, and mental effort. The affective response to dyspnea was greater in females, with significantly higher reports of anxiety, frustration, and fear related to dyspnea. HADS anxiety subscale scores were correlated with MDP dyspnea scores of breathing discomfort, immediate perception domain, and emotional response domain in males. In females, higher HADS anxiety scores were correlated with the emotional response domain only. Males with higher likelihood of anxiety experienced greater frustration, anger, and fear related to dyspnea; however, this was not the case for females.ConclusionIn respiratory outpatients, despite similar lung function impairment and mMRC scores, females experience greater breathing muscle work, chest tightness, and mental effort as well as significantly greater anxiety, frustration, and fear related to dyspnea.https://www.frontiersin.org/articles/10.3389/fmed.2025.1627496/fullanxietydyspneasex-differencesdepressionchronic lung disease
spellingShingle Kathryn M. Milne
Kathryn M. Milne
Kathryn M. Milne
Julia Zhang
Owen D. Harris
Jordan A. Guenette
Jordan A. Guenette
Jordan A. Guenette
Sex-differences in the multidimensional evaluation of dyspnea in respiratory outpatients
Frontiers in Medicine
anxiety
dyspnea
sex-differences
depression
chronic lung disease
title Sex-differences in the multidimensional evaluation of dyspnea in respiratory outpatients
title_full Sex-differences in the multidimensional evaluation of dyspnea in respiratory outpatients
title_fullStr Sex-differences in the multidimensional evaluation of dyspnea in respiratory outpatients
title_full_unstemmed Sex-differences in the multidimensional evaluation of dyspnea in respiratory outpatients
title_short Sex-differences in the multidimensional evaluation of dyspnea in respiratory outpatients
title_sort sex differences in the multidimensional evaluation of dyspnea in respiratory outpatients
topic anxiety
dyspnea
sex-differences
depression
chronic lung disease
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1627496/full
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