title: Interference of psychological factors in difficult-to-control asthma.
abstract: BACKGROUND
  Most patients with asthma can be controlled with suitable medication, but 5-10% of them remain difficult to control despite optimal management.
  
  
  OBJECTIVE
  We investigated whether patients with difficult-to-control asthma (DCA) or controlled asthma (CA) differ with respect to psychological factors, such as general control beliefs on life events.
  
  
  METHODS
  DCA was defined as an absence of control despite optimal management. Recent control was measured using the Asthma Control Questionnaire. General control beliefs were investigated using a Locus of Control scale (LOC).
  
  
  RESULTS
  Patients with DCA had a significantly higher external LOC as compared to patients with CA (P=0.01). In the DCA group, the hospital admission rate was highly significant in association with the external LOC (P=0.004) as compared to the internal LOC trend.
  
  
  CONCLUSIONS
  This study showed that patients with DCA had different general control beliefs which might have hampered their management and interfered with their therapeutic adherence. The present findings could enhance management of DCA in a clinical setting.
authors.affiliation: Clinique des Maladies Respiratoires, Hôpital Arnaud de Villeneuve, 371 Av du Doyen Gaston Giraud 34295 Montpellier Cedex 5, France. chanez@montp.inserm.fr
authors.forename: Laurence
authors.initials: L
authors.lastname: Halimi
authors.forename: Isabelle
authors.initials: I
authors.lastname: Vachier
authors.forename: Muriel
authors.initials: M
authors.lastname: Varrin
authors.forename: Philippe
authors.initials: P
authors.lastname: Godard
authors.forename: Gérard
authors.initials: G
authors.lastname: Pithon
authors.forename: Pascal
authors.initials: P
authors.lastname: Chanez
mesh_terms: D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000523:psychology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D018709:Statistics, Nonparametric; D017211:Treatment Failure
chemical_list: D018927:Anti-Asthmatic Agents