Asthma as a psychosomatic disease. The causes, scale of the problem, connection with alexithymia and asthma control

Abstract

Introduction: It is well known, that psychological factors may have an influence on evolution and course of asthma, however few information is available about the scale of a problem and the factors which are associated with the psychogenic asthma. The aim of the study was to estimate the coincidence of asthma and the psychosomatic diseases, to evaluate the impact of a stress and strong emotions on an asthma exacerbation and the level of alexithymia. The level of alexithymia was also compared with asthma control level. Material and methods: The study was conducted among 54 (75.9% female) patients with diagnosed asthma (mean age 54.37 ± 14.52 yrs). Research was carried out at SP CSK Warsaw. Patients filled in a questionnaire consisting of: Asthma Control Test (ACT), list of factors which may cause asthma excerbation, Toronto Alexithymia Scale 26 (TAS-26, E. S ́cigała, T. Maruszewski translation). Patients took part in an interview gathering information about diagnosed diseases in which the presence of psychological or behavioural influences is thought to have played a major role in the etiology of physical disorders or disorders connected with stress but presented by the patient as somatic symptoms. Following diseases have been included: atopic dermatitis, depression, anorexia nervosa, irritable bowel syndrome, panic disorder (based on ICD-10 guidelines). Statistical analysis was conducted with SPSS 14.00 PL package, the level of statistical significance was p < 0.05. To check the relationship between the qualitative variables the non parametric test for independent samples was used. Results: In 50% of cases patients with asthma had diagnosed at least one of following diseases: irritable bowel syndrome (n = 8), atopic dermatitis (n = 7), depression (n = 13), panic disorder (n = 9). Alexithymia was diagnosed in 11 cases (21.6%), relation between the level of alexithymia and stress and strong emotions was not found (χ2 = 0,106, p > 0.05). Stress and/or strong emotions were marked as factors causing asthma exacerbation in 33 cases (61.1%). In the 72.5% of cases the asthma control was badly controlled, in 17.6% the asthma control was good, and in 9.8% the asthma control was complete. There was no connection between the asthma control and alexithymia (χ2 = 0.358, p > 0.05). There was no relation between patients sex and the asthma control (χ2 = 0.605; p > 0.05). Conclusion: The high level of alexithymia among the patients with asthma, frequent coincidence of asthma and psychosomatic diseases and the distinct influence of stress and strong emotions on causing asthma exacerbations, proven in this study, confirm that asthma may be considered as the psychosomatic disease. © 2012 Via Medica.