Anxiety in asthma patients can be caused by dysfunctional breathing patterns that are difficult to distinguish from airflow obstruction, they say.

And panic during an acute exacerbation, say the authors, is a risk factor for the severe life-threatening form of the disease.

Dr J Kolbe from the University of Auckland in New Zealand and colleagues investigated risk factors for severe life-threatening asthma (SLTA) among patients admitted to hospital with asthma.

Patients admitted to a general hospital ward with acute asthma (n=239) were compared to those admitted to an intensive care unit with SLTA (n=77), with respect to prevalence of “specific adverse psychological factors”.

A random sample of community-based asthmatics was also recruited to provide normative data.

Between one and two days after admission a questionnaire was administered to the subjects.

When compared with the community-based asthmatics, those with acute and SLTA had a higher prevalence of anxiety and depression.

Specific adverse psychological factors were not risk factors for SLTA when compared with those admitted to hospital with acute asthma, but adverse psychological factors did increase the risk of hospitalization for acute asthma.

“High levels of anxiety may impair the ability to make correct self-management decisions, specifically impairing the ability to put into practice what is known,” said the study authors.

They added that there is a high prevalence of adverse psychological and social factors in patients with severe asthma, which has “major implications for asthma education and other strategies designed to improve self-management behavior”.

Reference: Kolbe et al, Thorax 2002;57:317-322

© Health Media Ltd 2002
http://www.health-news.co.uk