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31-01-2010 | Respiratory | Article

Near-fatal asthma attacks linked to psychological morbidity


Free abstract

MedWire News: Patients who have suffered a near-fatal asthma (NFA) attack have significantly higher levels of psychological morbidity for years after the event than other asthma patients, research shows.

Writing in the Journal of Psychosomatic Research, Isabel Vázquez (Universidad de Santiago de Compostela, Spain) and colleagues explain: “Several studies that have analyzed differences in psychological and self-management variables between patients with a NFA attack and asthmatics without a NFA attack (non-NFA) have shown conflicting results, probably due to the heterogeneity of the events studied and the selection of comparison groups.”

To investigate further, the team studied 44 stable asthma patients who had suffered an NFA attack a mean of 5.65 years previously and 44 non-NFA patients who were matched for age, gender, and asthma severity.

All participants were administered the Cognitive Depression Inventory, the Trait-Anxiety Scale, the Toronto Alexithymia Scale, the Practical Knowledge of Self-management questionnaire, and the Medication Adherence scale. Data on sociodemographic, clinical, functional, and morbidity variables were also collected.

The researchers found that NFA patients had significantly higher levels of anxiety than non-NFA patients, as indicated by scores on the Trait-Anxiety Scale of 23.84 and 16.86, respectively.

NFA patients also had more difficulties describing and communicating feelings than non-NFA patients, as indicated by respective mean scores on the Toronto Alexithymia Scale of 11.36 versus 8.90.

The team also found that NFA patients were slightly more likely to be depressed than non-NFA patients, but there were no significant differences between the groups regarding practical knowledge of their disease and self-management.

Vázquez and team conclude: “The findings of the present study show that trait-anxiety and difficulties describing feelings are more frequent in NFA patients than in non-NFA patients, trait-anxiety being the variable that best discriminates between both groups of patients. As NFA and control group patients were in stable situation, the observed differences are not due to the transitory emotional impact of the asthma attack.”

They add: “While our data do not clarify the direction of the relationship between NFA and both trait-anxiety and… alexithymia, they do underline the need to address anxiety and alexithymia in the management of asthma, not only due to its implication in the improvement of the patients' psychological well-being but also because these variables have been shown as factors that can interfere in adequate illness management.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Mark Cowen

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