Psychological distress and associated risk factors in bronchial asthma patients in Kuwait.(ORIGINAL CONTRIBUTION)(Statistical data)(Clinical report)

Byline: N. Panicker, P. Sharma, A. Al-Duwaisan

Context: Recent literature shows a high prevalence of psychological distress in bronchial asthma. Aim: To find the extent of psychological distress and associated risk factors in bronchial asthma patients in Kuwait. Design: Case-control study. Materials and Methods: In a study at Kuwait's allergy center, 102 patients aged 20-60 years with asthma (67%), asthma with allergic rhinitis (33%) completed a self-administered questionnaire (WHO-Five Well-being Index). A score below 13 was considered as psychological distress; and 13 and above, as normal. An equal number of controls, matched for age, gender, nationality, were also enrolled. Statistical Analysis: The data were analyzed using SPSS software, and proportions were tested with Chi-square or Fisher's test. Odds ratio (OR) with 95% confidence interval (CI) was calculated to quantify the risk factors. Results: A significantly large proportion (69%) of patients were found to be psychologically distressed, compared to 24% among controls (P < 0.001, OR = 7.5; 95% CI: 4-14). As many as 83.3% of cases, in the younger (20-30 years) age group, were distressed (P < 0.044), compared to other age groups. A declining trend in proportion of distressed cases with increasing age was observed (P < 0.013). A higher proportion of females (73.8%) and Kuwaitis (71.6%) with distress were observed, both among cases and controls. Conclusions: We found a high rate of poor well-being and psychological distress in patients suffering from asthma. Young patients and those with relatively short duration of illness, as well as asthmatic females, are more vulnerable to distress and need further psychological evaluation.

Introduction

There have been considerable studies on the relationship between asthma and psychological disturbance. Recent review of literature describes an increased prevalence of psychological comorbidity in adults with asthma. Previous research suggests that anxiety and depression are more common in patients with moderate-to-severe asthma than in the general population.[sup] [1] Persons with asthma who suffer from symptoms such as dyspnea and nocturnal awakening are at increased risk for psychological distress and depression. Several psychological and emotional factors have been noted to be associated with poor asthma control, near-fatal asthma attacks and asthma mortality.[sup] [1] Feldman et al. have found a very high rate (65%) of psychiatric disorders like mood changes and anxiety in a high-risk inner-city asthmatic patients. They suggested psychiatric disorders should be taken into account when treating asthma.[sup] [2]

Psychological distress, leading to depression, might be a risk factor for asthma-related morbidity and mortality.[sup] [3] Frequent hospital admissions with …