Near fatal asthma and psychopathological characteristics: a group-control study.
ABSTRACT Psychological factors may play a role in asthma. In particular, emotional upsets have been correlated with fatal asthma attacks, and an abnormal personality attitude is considered to be a risk factor in fatal asthma. Moreover, some authors have recently reported favourable asthma outcome in patients with severe asthma and psychiatric abnormalities, when psychoactive treatment was initiated. On the understanding that people with fatal and "near fatal asthma" (NFA) are components of the same subset of the asthmatic population, we undertook a study aimed at assessing the importance of personality and psychiatric factors in asthma mortality. Between June 1991 and December 1993, a sample of 17 patients with asthma who had experienced one or more near fatal asthma attacks (respiratory arrest, or need for respiratory assistance, or altered conscious state, or arterial carbon dioxide tension (Pa,CO2) > 6.7 kPa (50 mmHg)), and 17 control patients with asthma who had never experienced such an attack (control group) were enrolled. All patients underwent: 1) an interview concerning their personal and family psychiatric history; 2) a psychodiagnostic investigation by a battery of four of the most widely used psychiatric tools: Hamilton scales for anxiety and depression; Zung scales for anxiety and depression; and Minnesota Multiphasic Personality Inventory. No statistical difference was found in psychodiagnostic tests between study and control groups. The psychiatric history was similar in the two groups. Our results suggest that personality characteristics and psychiatric history are not related to asthma outcome, and that the psychiatric approach is not expected to be useful in preventing mortality in asthma.
- SourceAvailable from: Paul Lehrer
Article: Psychological aspects of asthma.[Show abstract] [Hide abstract]
ABSTRACT: Asthma can be affected by stress, anxiety, sadness, and suggestion, as well as by environmental irritants or allergens, exercise, and infection. It also is associated with an elevated prevalence of anxiety and depressive disorders. Asthma and these psychological states and traits may mutually potentiate each other through direct psychophysiological mediation, nonadherence to medical regimen, exposure to asthma triggers, and inaccuracy of asthma symptom perception. Defensiveness is associated with inaccurate perception of airway resistance and stress-related bronchoconstriction. Asthma education programs that teach about the nature of the disease, medications, and trigger avoidance tend to reduce asthma morbidity. Other promising psychological interventions as adjuncts to medical treatment include training in symptom perception, stress management, hypnosis, yoga, and several biofeedback procedures.Journal of Consulting and Clinical Psychology 07/2002; 70(3):691-711. · 4.85 Impact Factor
- Thorax 04/2002; 57(3):190-1. · 8.38 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: OBJECTIVE:Selective attention to GI sensations has been suggested as an important mechanism that affects symptom perception in patients with irritable bowel syndrome (IBS), but this hypothesis has not yet been tested empirically. Differential recall of words describing negative affect has been used to demonstrate that depressed patients selectively attend to negative affect words. This technique may be useful for examining selective attention to somatic sensations. The aim of this study was to determine whether patients with IBS demonstrate selective recall of GI sensations compared with neutral words and words describing respiratory sensations.METHODS:A total of 16 IBS patients, nine asthmatic patients (medical controls), and eight healthy controls were shown 10 GI sensation words or phrases, 10 respiratory sensation words or phrases, and 10 neutral words in random order for 3 s each. After a distraction task, subjects wrote down all of the words or phrases they could remember.RESULTS:As predicted, IBS patients were more likely to recall GI words than other categories. Asthmatic patients were more likely to recall respiratory words in comparison with healthy controls.CONCLUSIONS:IBS patients selectively recall words describing GI sensations; this suggests that they may selectively attend to GI sensations, thus supporting the cognitive-behavioral theory of IBS.The American Journal of Gastroenterology 05/2001; · 9.21 Impact Factor