title: Psychologic distress and maladaptive coping styles in patients with severe vs moderate asthma.
abstract: BACKGROUND
  Though several biologic factors have been suggested to play a role in the development and persistence of severe asthma, those associated with psychologic factors remain poorly understood. This study assessed levels of psychologic distress and a range of disease-relevant emotional and behavioral coping styles in patients with severe vs moderate asthma.
  
  
  METHODS
  Eighty-four patients (50% women, mean [M] age 46 years) with severe (n = 42) and moderate (n = 42) asthma were recruited. Severe asthma was defined according to American Thoracic Society criteria. Patients underwent demographic and medical history interviews and pulmonary function and allergy testing. Patients also completed questionnaires measuring asthma symptoms and the Millon Behavioral Medicine Diagnostic Inventory, which assesses psychologic distress and emotional/behavioral coping factors that influence disease progression and treatment.
  
  
  RESULTS
  After adjustment for covariates and applying a correction factor that reduced the significant P level to < .01, patients with severe vs moderate asthma reported experiencing more psychologic distress, including worse cognitive dysfunction (F = 6.72, P < .01) and marginally worse anxiety-tension (F = 4.02, P < .05). They also reported worse emotional coping (higher illness apprehension [F = 9.57, P < .01], pain sensitivity [F = 10.65, P < .01], future pessimism [F= 8.53, P < .01], and interventional fragility [F = 7.18, P < .01]), and marginally worse behavioral coping (more functional deficits [F = 5.48, P < .05] and problematic compliance [F = 4.32, P < .05]).
  
  
  CONCLUSIONS
  Patients with severe asthma have more psychologic distress and difficulty coping with their disease, both emotionally and behaviorally, relative to patients with moderate asthma. Future treatment studies should focus on helping patients with severe asthma manage distress and cope more effectively with their illness, which may improve outcomes in these high-risk patients.
authors.affiliation: Hôpital du Sacré-Coeur de Montréal, Research Center, Department of Chest Medicine, J-3190, 5400 Gouin West, Montreal, QC, Canada H4J 1C5. k-lavoie@crhsc.rtss.qc.ca
authors.forename: Kim L
authors.initials: KL
authors.lastname: Lavoie
authors.forename: Donald
authors.initials: D
authors.lastname: Bouthillier
authors.forename: Simon L
authors.initials: SL
authors.lastname: Bacon
authors.forename: Catherine
authors.initials: C
authors.lastname: Lemière
authors.forename: James
authors.initials: J
authors.lastname: Martin
authors.forename: Qutayba
authors.initials: Q
authors.lastname: Hamid
authors.forename: Mara
authors.initials: M
authors.lastname: Ludwig
authors.forename: Ron
authors.initials: R
authors.lastname: Olivenstein
authors.forename: Pierre
authors.initials: P
authors.lastname: Ernst
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000503:physiopathology* / Q000523:psychology*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012129:Respiratory Function Tests; D012307:Risk Factors; D012882:Skin Tests; D013315:Stress, Psychological / Q000503:physiopathology*; D011795:Surveys and Questionnaires