© 2002 Thorax
EDITORIAL
Asthma
Psychological factors in asthma control and attack risk
Chest Clinic, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, UK
Correspondence to:
Correspondence to:
Dr L M Osman, Chest Clinic, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, UK;
l.osman@abdn.ac.uk
The risk of asthma episodes may depend on a complex relationship between psychological factors and the experience of a recent attack.
Keywords: asthma; attack context; psychological factors
In a series of Australian studies Yellowlees,1 Ruffin,2 and Campbell3 have found high rates of anxiety and panic disorder among patients who have suffered near fatal asthma episodes. In the UK Ayres and coworkers have found a high lifetime prevalence of psychiatric symptoms and psychiatric morbidity in patients with brittle asthma.4,5 Both the Australian studies and that by Ayres et al report a consistent pattern of high levels of denial of asthma and delay in seeking help in acute attacks. The confidential enquiries into asthma deaths6–8 suggest that psychological factors including denial and delay contribute to some deaths. Patients who had died from asthma were more likely to be those who found it difficult to cooperate with medical management.
However, these studies only refer to a small minority of asthma patients, are post hoc, and may be relevant only to a special group of asthmatic subjects. It is not
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