Difficult to control asthma and psychiatric comorbidity

Aim of this study was to describe psychopathology in difficult asthma, both major mental and personality disorders, based on diagnostic interviews. [1]

A total of 51 patients with difficult asthma were diagnosed at the start of the treatment programme using two structured clinical interviews for both major mental (SCID-I) and personality disorders (SCID-II) according to DSM-IV-TR. About 55% of the patients with difficult asthma had a psychiatric disorder of which 89% was undiagnosed and untreated before being interviewed. About 49% had a minimum of one major mental disorder of which the cluster of anxiety disorders was the most common cluster of major mental disorders, followed by somatoform disorders. About 20% were diagnosed with a personality disorder. Of the 10 patients with a personality disorder, 9 had an obsessive–compulsive personality disorder.

The authors conclude that their study highlights the importance of offering patients with difficult asthma a psychiatric diagnostic interview and/or a psychiatric consultation as part of their routine medical examination and provision of appropriate psychiatric treatment.

1          Prins LCJ, van Son MJM, van Keimpema ARJ, et al. Unrecognised psychopathology in patients with difficult asthma: major mental and personality disorders. Br J Psychiatry Open 2015;1:14–7. doi:10.1192/bjpo.bp.115.000182