title: Treatment of psychological factors in a child with difficult asthma: a case report.
abstract: Difficult asthma is defined as the persistence of asthma symptoms, abnormal pulmonary function showing airway obstruction, and continued requirement for short-acting bronchodilator therapy, despite adequate treatment with inhaled corticosteroids. It calls for a thorough evaluation of the patient to look into alternate and complicating diagnoses. The authors report a case of a 9-year-old patient with difficult asthma who failed to respond to conventional therapy. Although it was recognized that he had a number of potential medical complicating factors including allergies, chronic sinusitis, and gastroesophageal reflux, a psychological intervention using hypnosis ultimately appeared to help alleviate his symptoms completely. Thus, psychological evaluation and intervention should be considered early in the course of management of a patient with difficult asthma, because it may help avoid time-consuming and expensive investigations of potential complicating factors, and it may yield rapid improvement in the patient's clinical condition.
authors.affiliation: Upstate Medical University, State University of New York, Syracuse, New York 13210, USA. anbarr@upstate.edu
authors.forename: Ran D
authors.initials: RD
authors.lastname: Anbar
authors.forename: Shagun
authors.initials: S
authors.lastname: Sachdeva
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D001249:Asthma / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D001326:Autogenic Training; D002648:Child; D015897:Comorbidity; D003299:Cooperative Behavior; D006801:Humans; D006990:Hypnosis / Q000379:methods*; D033183:Interdisciplinary Communication; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D010348:Patient Care Team; D012803:Sick Role; D013404:Suggestion
chemical_list: D000305:Adrenal Cortex Hormones