In a recent review published in the journal Asthma Research and Practice, a team of researchers explored the role of psychological factors associated to the unsuccessful fulfillment of optimal levels of asthma control.
Regular treatment with inhaled corticosteroids (ICS) or ICS plus long-acting beta2-agonists (LABA), has been proven to offer asthma control to patients who suffer with the condition. Nevertheless, some patients do not respond to this type of therapy. Severe asthma severity has been found to affect about 5-10 % of the total asthmatic population.
The goal of asthma therapy is to reach and sustain disease control, daily activity limitation, diminishing symptoms, and the risks for long-term morbidity and for life-threatening exacerbations. An unsuccessful asthma treatment depends on the presence and interaction of different causes related to the disease itself, the treatment, the patient and the physician.
Different psychological factors also play a role in daily asthma management. The impact of the disease in patients’ daily routines, ideas regarding asthma, the subjective interpretation of symptoms, and therapeutic adherence are related to psychological aspects of coping with asthma.
The presence of the asthma may have an impact on patients’ affective sphere, which may be an obstacle to an optimal management of the disease. It is now recognized that asthma influences mental health and vice versa, and that an association exists between the level of asthma control and psychological functioning.
In a review titled “Psychological aspects in asthma: do psychological factors affect asthma management?” Ilaria Baiardini and colleagues from the Allergy & Respiratory Diseases Department at Azienda Ospedaliera Universitaria IRCCS San Martino in Genoa, Italy conducted a Medline search and retrieved a total of 5,510 articles addressing different psychological key concepts, constructs and variables. The researchers’ goal was to explore the role of psychological factors associated with the unsuccessful fulfillment of optimal levels of asthma control, especially in patients suffering from severe asthma.
The researchers found that psychological aspects of asthmatic patients and the presence of mental problems are linked to both asthma severity and level of disease control.
According to the researchers, difficulties in reaching asthma treatment objectives indicated by current guidelines also depends on psychological factors such as symptom perception, alexithymia, coping strategies, and mood disorders. Despite numerous data supporting this association, a causal relationship between asthma and mental health remains unknown, making the hypothesis of a bidirectional influence more plausible. Independent of the nature of this association, when a psychological problem or difficulty is present, it interferes with optimal disease management, especially in patients with severe asthma and poor control over the disease. At the same time, the psychological characteristics of asthmatic patients have an influence on symptoms’ recognitions, daily management and disease outcomes.
The researchers suggest that a screening of mental symptoms and psychological aspects that are known as being associated to asthma could lead to planning appropriate interventions to better control asthma and improve the patient’s well-being.