Psychological morbidity and coping skills in patients with brittle and non-brittle asthma: a case-control study
Abstract
BACKGROUND: An association between psychological morbidity and asthma is well recognized and an increase in negative psychosocial factors in brittle asthma has been previously reported. Such factors, apart from affecting patient perceptions, may alter patients' self-management of their condition. METHODS: We have undertaken a case-control study on 29 well characterized brittle and non-brittle asthmatics in the West Midlands Region to assess their level of psychological morbidity, using the General Health Questionnaire (GHQ) and the living with asthma questionnaire, and their responses to changes in asthma symptoms, using the Asthma Symptom Checklist and a taped interview. RESULTS: Significant differences in GHQ (mean score brittle 19.5 vs non-brittle 7.2, P = 0.0002) and living with asthma (mean score brittle 1.30 vs non-brittle 1.00, P = 0.002) reinforced the presence of psychological factors in this group of patients with severe asthma. Interviews regarding responses to hypothetical asthma attacks showed that patients with brittle asthma delayed seeking medical attention more often than those with non-brittle asthma and instead preferred to self-administer beta-agonist medication. Sixteen (55.2%) of the 29 patients with brittle asthma would have delayed 7 days before seeking medical attention in a slow onset attack compared with 6/29 (20.7%) in the non-brittle group. In a fast onset attack 14 (48.3%) patients with brittle asthma would not have summoned help, despite finding it difficult to walk to the kitchen for a drink whereas in the non-brittle group 24 out of 29 (82.8%) would have summoned help. Levels of family support tended to be lower in patients with brittle asthma (mean family APGAR 7.3 vs 8.65 P = 0.09). CONCLUSIONS: Brittle asthma is associated with greater psychological morbidity and altered strategies for coping with deteriorating asthma symptoms. Attention should be paid to the presence of such factors in the management of patients with brittle asthma.
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People with brittle asthma demonstrate even greater comorbidity and maladaptive coping styles.
“People with brittle asthma (difficult-to-control asthma with severe, recurrent attacks) demonstrate even greater comorbidity and maladaptive coping styles.11”
From A systematic review of psychological, physical health factors, and quality of life in adult asthma (2019) · cites this paper as [11]
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- Authors
- MILES, J. E., GARDEN, G. M. E., TUNNICLIFFE, W. S., CAYTON, R. M., & AYRES, J. G.
- Affiliations
- Heartlands Hospital (GB)
- Lincoln County Hospital (GB)
- ORCID
- GARDEN, G. M. E.
- Venue
- Clinical <html_ent glyph="@amp;" ascii="&"/> Experimental Allergy
- Publisher
- Wiley
- Published
- 1997-10
- Volume
- 27
- Issue
- 10
- Pages
- 1151-1159
- ISSN
- 0954-7894 (ISSN-L)
- 1365-2222
- OpenAlex
- W2097402532
- Cited by
- 68
- References
- 39
- Citations by year
- 2024: 1 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 1 · 2018: 2 · 2016: 3 · 2015: 2 · 2014: 4 · 2013: 3
- FWCI
- 2.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical & Experimental Allergy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Keywords
- brittle asthma, psychological morbidity, coping strategies, severe asthma, asthma self-management, family support, psychosocial factors
- MeSH terms
- Adrenergic beta-Agonists, Asthma, Drug Therapy, Humans, Peak Expiratory Flow Rate, Quality of Life, Surveys and Questionnaires, Severity of Illness Index, Social Support, Case-Control Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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