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Further evidence that the wealthier are healthier: negative life events and asthma-specific quality of life
  1. R J Wright
  1. Correspondence to:
    Dr R J Wright
    Channing Laboratory, Brigham & Women’s Hospital, Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA;rosalind.wright{at}

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Association between psychological stress and asthma expression and morbidity

In this issue of Thorax, Archea et al1(see p 139) add to the growing number of studies linking psychological stress to asthma expression and morbidity. To date, studies have reported an association between various measures of life stress and both the onset of asthma or precedent phenotypes2,3 and exacerbations of established disease.4–6 Hypothesised mechanisms underlying the association between stress and asthma expression implicate reciprocal relationships between neural, hormonal and immunological pathways that have been extensively reviewed previously.7,8 Evidence demonstrating that psychological stress influences the expression of inflammatory cytokine patterns in patients with asthma or those at risk of developing the disease supports these theories.9,10 Others have shown that physiological changes, including neuroimmune and genetic processes, may lead to differential responses to therapeutic interventions for asthma and atopic disorders.11,12

The current work by Archea et al1 underscores that psychological factors may also be more indirect, albeit equally important, determinants of asthma morbidity by influencing how individuals perceive and manage their disease. They aimed to examine the relationship between negative life events (NLEs) and asthma-specific quality of life (AQoL), and also to understand the interrelationships among AQoL, asthma severity and socioeconomic status (SES). These cross-sectional results show a relationship between the frequency of experiencing NLEs, a measure of psychological stress, and AQoL among 189 adults with asthma. Those experiencing a greater number of NLEs reported a worse AQoL, a relationship seen across all …

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