Psychological aspects of asthma.

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.

Hospitalizations for asthma among adults exposed to the September 11, 2001 World Trade Center terrorist attack

“…Potential pathways that link mental health conditions to increased asthma morbidity may be biological as well as behavioral. For instance, increased inflammation and activation of stress pathways have been described in depression and PTSD; the latter mechanism may lead to the bronchoconstriction associated with an asthma exacerbation, and the former may lead to inflamed airways [32]. Similarly, mental health conditions have been linked to decreased adherence to asthma controller medications and other important selfmanagement behaviors [29,32].…”

“…For instance, increased inflammation and activation of stress pathways have been described in depression and PTSD; the latter mechanism may lead to the bronchoconstriction associated with an asthma exacerbation, and the former may lead to inflamed airways [32]. Similarly, mental health conditions have been linked to decreased adherence to asthma controller medications and other important selfmanagement behaviors [29,32]. Serious mental illness has been found to predict subsequent hospitalization for asthma exacerbations and chronic obstructive pulmonary disease [33].…”

Asthma-related comorbidities

“…Anxiety, depression and panic disorders are more frequent in asthmatic patients than in the general population [120][121][122][123][124][125]. Depression may affect control of asthma in reducing adherence to the treatment and follow-up.…”

“…In another study, ten Brinke et al concluded that factors significantly associated with frequent asthma exacerbations in severe asthma are severe nasal sinus disease, GERD, recurrent respiratory infections, psychological dysfunction and OSA [192]. Severe asthma has also been associated with psychological disorders such as anxiety, depression and lack of trust towards healthcare providers [121,124,125].…”

Is Atopy Related to Neuroticism, Stress, and Subjective Quality of Life?

“…Epidemiological and clinical studies have examined the relationships between several psychosocial factors and allergic diseases, predominantly asthma (6,7). Some of the studies examined the relationships between allergic diseases and various personality traits, such as neuroticism (8,9), anxiety (10)(11)(12), extraversion/introversion (9), shyness (13,14), and depression (11).…”