Higher Lifetime Stress and Symptom Burden Contribute to the Occurrence of Shortness of Breath.

The sample was relatively homogeneous in gender, race and ethnicity, so findings may not generalize to more diverse groups. Patients who refused participation were often overwhelmed by cancer treatment, so stress levels may be underestimated. Shortness of breath was measured by patient report only, without pulmonary function or neuroimaging. The study did not capture detailed causes of shortness of breath or use of treatments for it. Stress and symptom measures were completed at enrollment, so the study cannot show that stress or symptoms preceded the shortness of breath profile. The study found associations, not proof that stress, trauma, anxiety, depression, pain, fatigue or sleep problems cause shortness of breath. The Increasing class did not show the same stress pattern, and its risk factors remain unclear.

The paper is tagged as supported by NIH extramural and non-U.S. government research. Dr. Wong reported that an immediate family member works for Genentech with stock ownership and that Dr. Wong receives UpToDate royalties. The remaining authors declared no conflicts.

Do not conclude that stress, trauma, anxiety or pain caused shortness of breath. These factors were measured at enrollment and only associated with shortness of breath profiles, and no treatment was tested.