Childhood asthma complicated by anxiety: an application of cognitive behavioural therapy.
OBJECTIVE
To identify characteristics within the patient and the environment that might be instrumental in triggering and maintaining an episode of asthma in children whose objective lung function tests suggested a less severe exacerbation than the subjective report and behaviour indicated, and also to investigate the efficacy of a cognitive behavioural intervention, using the paradigm of a panic anxiety disorder.


METHODS
A retrospective investigation of 23 case records and psychosocial histories, focusing on the characteristics of the sample and the number of presentations and admissions before and after the intervention, which is described.


RESULTS
Children aged 10-12 years predominated. A precipitating event triggered a fear that their condition had deteriorated in the context of a growing understanding that asthma in a child could be fatal. A reduction in presentations and admissions post-intervention is shown.


CONCLUSIONS
The paradigm of panic disorder is useful to understand the sudden onset of apparent deterioration in the severity of asthma when objective lung function tests do not support the subjective experience.
Park
S J
SJ
Mental Health Service, The Royal Children's Hospital, Parkville, Melbourne, Australia.
Sawyer
S M
SM
Glaun
D E
DE
D000293:Adolescent; D001007:Anxiety / Q000209:etiology* / Q000628:therapy*; D001249:Asthma / Q000523:psychology*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005239:Fear; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008960:Models, Psychological; D015985:Precipitating Factors; D012017:Referral and Consultation; D012189:Retrospective Studies