Psycho-demographic profile in severe asthma and effect of emotional mood disorders and hyperventilation syndrome on quality of life

Abstract

Background: Severe asthma affects a small population but carries a high psychopathological risk. Therefore, the psychodemographic profile of these patients is of interest. A substantial prevalence of anxiety, depression, alexithymia and hyperventilation syndrome in severe asthma is known, but contradictory results have been observed. These factors can also affect patients’ quality of life. For this reasons, our purpose is to evaluate the psychodemographic profile of patients with severe asthma and assess the prevalence of anxiety, depression, alexithymia and hyperventilation syndrome and their impact on the quality of life of patients with severe asthma. Methods: A cross‑sectional study of 63 patients with severe asthma. Their psychodemographic profile was evaluated using the Hospital Anxiety and Depression Scale (HADS), Toronto Alexithymia Scale (TAS‑20), Nijmegen questionnaire and Asthma Control Test (ACT) to determine the state of anxiety and depression, alexithymia, hyperventilation syndrome and control of asthma, respectively. Quality of life was assessed with the Mini Asthma Quality of Life Questionnaire (Mini‑AQLQ). Results: The mean age was 60 ± 13.6 years. Personal psychopathological histories were found in 65.1% of participants, and 8% reported previous suicidal attempts. The rate of anxiety and/or depression (HADS ≥ 11) was 68.3%. These patients present higher scores on the TAS‑20 (p < 0.001) for the level of dyspnea (p = 0.021), and for emotional function (p = 0.017) on the Mini‑AQLQ, compared with patients without anxiety or depression. Alexithymia (TAS‑20 ≥ 61) was observed in 42.9% of patients; these patients were older (p = 0.037) and had a higher HADS score (p = 0.019) than patients with asthma without alexithymia. On the other hand, patients with hyperventilation syndrome (Nijmegen ≥ 23) scored higher on the HADS (p < 0.05), on the Mini‑AQLQ (p = 0.002) and on the TAS‑20 (p = 0.044) than the group without hyperventilation syndrome. Quality of life was related to anxiety‑depression symptomatology (r = − 0.302; p = 0.016) and alexithymia (r = − 0.264; p = 0.036). Finally, the Mini‑AQLQ total score was associated with the Nijmegen questionnaire total score (r = − 0.317; p = 0.011), and the activity limitation domain of the Mini‑AQLQ correlated with the ACT total score (r = 0.288; p = 0.022). Conclusions: The rate of anxiety, depression, alexithymia and hyperventilation syndrome is high in patients with severe asthma. Each of these factors is associated with a poor quality of life