The role of psychological factors in the management of severe asthma in adult patients
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Pneumonology Department, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Thomai Prapa   

Pneumonology University Clinic, Aristotle University of Thessaloniki, “G. Papanikolaou” General Hospital, Greece
Pneumon 2017;30(4):236-242
Asthma is a long-lasting and life threatening condition. Patients with asthma often have unpleasant subjective complaints regarding their respiratory symptoms. Many studies highlight the association between psychosocial factors and asthma. Asthmatic patients have higher prevalence of anxiety and depressive disorders. Focusing on physiological and psychological elements is important for treatment. Management strategies combining pharmacologic with non-pharmacologic treatment are more effective in controlling asthma. Psychotherapeutic interventions aim to reduce patients’ complaints, improve quality of life and disease self-management. Various psychotherapeutic approaches/techniques have been studied; Cognitive Behavioral and Analytic Therapy, Psychodynamic psychotherapies, Counseling, psycho-educational interventions, self-management education, relaxation, music therapies, hypnosis, biofeedback. Meta-analytic studies show that psychotherapy works. Following this, many studies tried to specify if psychotherapy is effective specifically for patients with moderate to severe asthma. Results show that psychological interventions have a positive supplementary impact on patients’ traditional medical treatment. Variables examined are health-care services utilization, asthma symptoms, lung function, medication use, absence from work, quality of life, coping skills, self efficacy, locus of control, anxiety, depression. Future research should focus on high-quality, well-conducted and reported randomized trials. Research on psychological interventions in asthmatic patients provide the health care professionals with accurate information about the appropriate psychotherapeutic technique and the frequency of intervention needed for each patient. Asthma morbidity and mortality are still increasing and severe asthma accounts for half of the health service costs related to asthma. Therefore, it is urgent for patients, health-care services and professionals to manage and reduce asthmatic patients’ symptoms and, by extension, hospital visits and admissions.
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