Aim To examine if psychosocial variables; ie, personality, ways of coping, locus of control, levels of anxiety and depression and levels of social deprivation, could predict levels of lung function and numbers of exacerbations in severe asthma.

Methods Participants all had severe asthma. Data on numbers of exacerbations was collected retrospectively over an 8-year period and levels of lung function assessed (FEV1% predicted and FEV1/FVC% predicted. Predictor variables measured using EPQ (personality), HADS (anxiety and depression), MHLOC (locus of control), WCC (ways of coping) and an individual social deprivation score. Standard multiple regression analysed the relationship between these predictor variables and the criterion variables of levels of lung function and numbers of exacerbations.

Results N=102 from a severe asthma clinic in the midlands. High levels of depression and moderate levels of social deprivation showed significant relationships to high numbers of exacerbations (R²=0.458, Beta value=0.636, p=0.009 and R²=0.581. Beta value=0.280, p=0.009 respectively). No relationship was found between the predictor variables and level of lung function.

Conclusion There are predictor variables which have a significant influence on the morbidity of severe asthma, which cannot be treated by conventional management techniques. Further work needs to be done to explore these variables and to develop management strategies for them in people with severe asthma.