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Vol. 47. Issue 2.
Pages 73-78 (January 2011)
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Vol. 47. Issue 2.
Pages 73-78 (January 2011)
Original Article
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Psychological Profile of Patients with Bronchial Asthma and Functional Dyspnea: A Comparison with a Non-Asthmatic Population and Impact on the Disease
Perfil psicológico de los pacientes con asma bronquial y disnea funcional: comparación con población no asmática e impacto sobre la enfermedad
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Carlos Martínez-Riveraa,e,
Corresponding author
29002cmr@comb.cat

Corresponding author.
, M. del Carmen Vennerab,e, Conchita Cañetec, Santiago Bardagíd, César Picadob,e
a Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
b Servicio de Neumología, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Spain
c Servicio de Neumología, Hospital General de L’Hospitalet de Llobregat, L’Hospitalet de Llobregat, Barcelona, Spain
d Servicio de Neumología, Hospital General de Mataró, Mataró, Barcelona, Spain
e Centro de Investigaciones Biomédicas en Red Enfermedades Respiratorias (CIBERES)
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Abstract
Background

Few studies analyze the relationship between anxiety and alexithymia with dysfunctional breathing (DB) and its impact on quality of life and asthma control. The aim of this study was to assess the prevalence of DB in asthma, its impact on quality of life and asthma control, and its relationship with anxiety and alexithymia.

Patients and methods

We performed a cross-sectional study of 264 asthmatic patients and 111 control subjects. Both groups completed the following questionnaires: quality of life (AQLQ), alexithymia (TAS-20), anxiety (STAI) and DB (Nijmegen). We evaluated each asthma patient for asthma severity, dyspnoea, exacerbation and control of the disease (ACT test).

Results

38% of asthmatics and 5.5% of non-asthmatics had DB. Asthma subjects had more anxiety and were more alexithymic. Asthmatics with DB had significantly more anxiety, more alexithymia, poorer asthma control, more exacerbations and poorer quality of life than asthmatics without DB. Asthmatics with an ACT<19, a score >3 in the emotion subscale of the AQLQ, who were being treated for anxiety and scored >19 on the alexithymia subscale that assesses difficulty in identifying emotions, showed ORs for DB of 2.6 (1.1–5.9), 6.8 (2.9–15.8), 4.4 (1.9–9.8) and 3.3 (1.5–7), respectively. A predictive DB model was constructed for asthma patients.

Conclusions

We have demonstrated the close relationship between anxiety, alexithymia and DB in asthmatics, as well as the significant impact of DB on the control and quality of life of asthma patients.

Keywords:
Asthma
Dysfunctional breathing
Anxiety
Asthma control
Resumen
IIntroducción

Pocos estudios analizan la relación de la ansiedad o la alexitimia con la disnea funcional (DF) y su impacto en calidad de vida y control del asma. El objetivo de este estudio fue evaluar la prevalencia de la DF en el asma, su repercusión sobre la calidad de vida y el control del asma y su relación con la ansiedad y la alexitimia.

Pacientes y métodos

Se realizó un estudio transversal de 264 pacientes asmáticos y 111 controles. Ambos grupos cumplimentaron los siguientes cuestionarios: calidad de vida (AQLQ), alexitimia (TAS-20), ansiedad (STAI) y DF (Nijmegen). En asmáticos se evalúo: gravedad del asma, grado de disnea, exacerbaciones y control de la enfermedad (test ACT).

Resultados

Un 38% de asmáticos y un 5,5% de no asmáticos tenían DF. Los asmáticos tenían más ansiedad y eran más alexitímicos. Los asmáticos con DF tenían de manera significativa más ansiedad, más alexitimia, peor control del asma, más exacerbaciones y peor calidad de vida que asmáticos sin DF. Los asmáticos con ACT<19, una puntuación>3 en la subescala de emoción del AQLQ, que estaban siendo tratados para ansiedad y que puntuaban>19 en la subescala de alexitimia que evalúa dificultad para identificar emociones mostraban OR para DF de 2,6 (1,1–5,9), 6,8 (2,9–15,8), 4,4 (1,9–9,8) y 3,3 (1,5–7), respectivamente. Se construyó modelo predictivo de DF en asmáticos.

Conclusiones

Se demuestra la relación estrecha entre ansiedad, alexitimia y DF en asmáticos, así como importantes repercusiones que tiene la DF sobre el control y calidad de vida del asmático.

Palabras clave:
Asma
Disnea funcional
Ansiedad
Control del asma
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