title: Psychopathology in difficult asthma.
abstract: OBJECTIVE
  Within the asthma population, difficult asthma (DA) is a severe condition in which patients present with frequent exacerbations, hospitalizations and emergency room visits. The identification and treatment of psychopathology is included in the management of DA. Psychopathology is supposed to predispose patients to DA or vice versa; psychopathology may develop as a consequence of DA. We reviewed the available literature on empirical findings regarding psychopathology in adult patients with DA.
  
  
  METHODS
  Studies in English language journals using MEDLINE, Cochrane and PsycINFO databases, were retrieved by an electronic search published from 1990 till July 2014.
  
  
  RESULTS
  Literature on psychopathology in DA is scarce. The search identified 16 articles of which only 6 articles were specifically about psychopathology in adult patients with DA. Almost half of the patients with DA had evidence of psychopathology at both syndrome and symptom level. Moreover, psychopathology appeared to be related to frequent exacerbations in patients with DA.
  
  
  CONCLUSIONS
  This literature review suggests a high prevalence of psychopathology of patients with DA, although it remains unclear whether psychopathology occurs more often in DA compared to "stable asthma". More research is needed on a possible role of psychopathology on clinical signs and symptoms in DA.
authors.affiliation: a Altrecht Psychosomatic Medicine , Zeist , The Netherlands .
authors.forename: Lonneke C J
authors.initials: LC
authors.lastname: Prins
authors.forename: Maarten J M
authors.initials: MJ
authors.lastname: van Son
authors.forename: Anton R J
authors.initials: AR
authors.lastname: van Keimpema
authors.forename: Dirk
authors.initials: D
authors.lastname: van Ranst
authors.forename: Antoinette
authors.initials: A
authors.lastname: Pommer
authors.forename: Jan-Willem G
authors.initials: JW
authors.lastname: Meijer
authors.forename: Victor J M
authors.initials: VJ
authors.lastname: Pop
mesh_terms: D001249:Asthma / Q000145:classification / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D012720:Severity of Illness Index
keywords: Difficult asthma; psychology; psychopathology