Research question:
1. What is the relationship between breathlessness, anxiety and depression among people with respiratory disease?
2. Do the existence of breathlessness, anxiety and depression affect the key clinical outcome?
Aims:
1. to examine the associations between breathlessness, anxiety and depression
2. to examine the causal relationship between breathlessness, anxiety and depression through Mendelian randomisation
3. to examine the neuroimaging mechanism of breathlessness, anxiety and depression.
The background and scientific rationale of the proposed research project in general!
Respiratory diseases, including chronic obstructive pulmonary disease (COPD), asthma, and lung disease, pose a global burden, with breathlessness as their most debilitating and distressing symptom. Beyond physical impairment, breathlessness is strongly linked to mental health disorders, such as anxiety or depression. This bidirectional association imposes profound burdens: mental health distress could amplify subjective breathlessness perception, while persistent breathlessness triggers fear, avoidance behaviours, and neurobiological stress responses that exacerbate anxiety and depression. Despite this clinical urgency, current management strategies often address respiratory symptoms and mental health in isolation, failing to target the shared neurobiological mechanisms underlying both conditions. Gaps remain in understanding how pathways integrate respiratory and emotional signals, and how these interactions modulate disease progression and treatment outcomes. It is important to investigate these neurobiological links to develop integrated interventions that improve both physical function and mental well-being.