Psychological profile of patients with bronchial asthma and functional dyspnea: a comparison with a non-asthmatic population and impact on the disease

Background: Few studies have analysed the relationship between anxiety and alexithymia with functional dyspnea (FD) and its impact on quality of life and asthma control. The aim of this study was to assess the prevalence of DD 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 controls. Both groups completed the following questionnaires: quality of life (AQLQ), alexithymia (TAS-20), anxiety (STAI) and FD (Nijmegen). In asthmatics were evaluated: asthma severity, dyspnoea, exacerbation and control of the disease (ACT test).

Results: 38% of asthmatics and 5.5% of non-asthmatics had FD. Asthmatics had more anxiety and were more alexithymic. Asthmatics with FD had significantly more anxiety, more alexithymia, poor control of asthma, more exacerbations and poorer quality of life, that asthma without DD. 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 FD 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 model of FD was constructed.

Conclusions: We demonstrated the close relationship between anxiety, alexithymia and DD in asthmatics, as well as the significant impact of FD on the control and quality of life of this asthmatics.