Background: Asthma is a major public health problem, and its prevalence is increasing in both developed and developing countries in recent years. Anxiety and panic are known to be associated with bronchial asthma with a variety of impacts on clinical presentation, treatment outcome, comorbidities, quality of life, and functional disability in patients with asthma. These psychological factors can directly exacerbate asthma symptoms through hyperventilation, patients’ overuse of as-needed asthma medications, more frequent hospital admissions, longer hospital stays and more frequent steroid treatment.
Aim: This study aims to explore the pattern of panic symptoms,
prevalence and severity of panic disorder (PD), quality of life, and disability
in them.
Methods: A hospital-based cross-sectional study was conducted in
the Psychiatry and Chest Medicine Outpatient Department of a tertiary care
hospital between January 2012 and June 2013. Sixty consecutive patients of
bronchial asthma were interviewed using a semistructured proforma, Panic and
Agoraphobia scale, WHO Quality of Life (QOL) BREF scale, and WHO disability
schedule II (WHODAS II). Data were analysed in IBM SPSS version 21 (IBM Inc.)
software. Sociodemographic details, clinical data and scores of various scales
were compared between asthmatics with and without panic disorder using the
Chi-square and unpaired 𝑡-test.
Results: The Mean duration of bronchial asthma in this study group
was 7.8 years. Though 60% of the participants had panic symptoms, only 46.7%
had diagnosable panic attacks according to DSM-IV-TR diagnostic criteria, and
33.3% had PD. Most common symptoms were “sensations of shortness of breath or
smothering,” “feeling of choking,” and “fear of dying”, found in 83.3% of the
participants. The result showed that 73.3% of the participants had poor quality
of life, which was most impaired in the physical and environmental domains. In
this study, 55% of the participants had disability score more than the mean
(18.1). A statistically significant association was observed between WHODAS
scores and the severity of both panic disorder and asthma.
Conclusion: One-third of the participants had panic disorder with
a significant effect on physical and environmental domains of quality of life.
Patients with more severe PD and bronchial asthma had more disability. This
study highlights the significant comorbidity of anxiety and panic disorder in
asthma, highlighting the need for future research into the underlying
biological and cognitive mechanisms.
Author
(s) Details
A. D. Faye
Department of Psychiatry, Datta Meghe Medical College, Wanadongri, Nagpur,
Maharashtra, 441110, India.
S. Gawande
Department of Psychiatry, NKP Salve Institute of Medical Sciences and Lata
Mangeshkar Hospital, Digdoh Hills, Hingna Road, Nagpur, Maharashtra 440019,
India.
R. Tadke
Department of Psychiatry, NKP Salve Institute of Medical Sciences and Lata
Mangeshkar Hospital, Digdoh Hills, Hingna Road, Nagpur, Maharashtra 440019,
India.
V. C. Kirpekar
Department of Psychiatry, NKP Salve Institute of Medical Sciences and Lata
Mangeshkar Hospital, Digdoh Hills, Hingna Road, Nagpur, Maharashtra 440019,
India.
S. H. Bhave
Department of Psychiatry, NKP Salve Institute of Medical Sciences and Lata
Mangeshkar Hospital, Digdoh Hills, Hingna Road, Nagpur, Maharashtra 440019,
India.
A. P. Pakhare
Department of Community and Family Medicine, All India Institute of Medical
Sciences, Bhopal 462020, India.
B. Tayade
Department of Chest Medicine, NKP Salve Institute of Medical Sciences and
Lata Mangeshkar Hospital, Digdoh Hills, Hingna Road, Nagpur, Maharashtra
440019, India.
Please see the book here:- https://doi.org/10.9734/bpi/aodhr/v1/5321
