Abstract
Background. Anxiety and panic are known to be associated with bronchial asthma with variety of impact on clinical presentation, treatment outcome, comorbidities, quality of life, and functional disability in patients with asthma. This study aims to explore the pattern of panic symptoms, prevalence and severity of panic disorder (PD), quality of life, and disability in them. Methods. Sixty consecutive patients of bronchial asthma were interviewed using semistructured proforma, Panic and Agoraphobia scale, WHO Quality of life (QOL) BREF scale, and WHO disability schedule II (WHODAS II). Results. Though 60% of the participants had panic symptoms, only 46.7% had diagnosable panic attacks according to DSM IV TR diagnostic criteria and 33.3% had PD. Most common symptoms were “sensations of shortness of breath or smothering,” “feeling of choking,” and “fear of dying” found in 83.3% of the participants. 73.3% of the participants had poor quality of life which was most impaired in physical and environmental domains. 55% of the participants had disability score more than a mean (18.1). Conclusion. One-third of the participants had panic disorder with significant effect on physical and environmental domains of quality of life. Patients with more severe PD and bronchial asthma had more disability.
Highlights
Asthma is a major public health problem and its prevalence is increasing in both developed and developing countries in recent years [1, 2]
Though studies have suggested an association between asthma and mental disorders, there are very few Indian studies that demonstrate the association of asthma and panic disorder (PD)
This study showed that the mere presence of asthma and absence of panic disorder can lead to poor quality of life as indicated by 63.6% of the participants without panic disorder having Quality of life (QOL) score less than 200 (Table 6)
Summary
Asthma is a major public health problem and its prevalence is increasing in both developed and developing countries in recent years [1, 2]. Panic and anxiety can directly exacerbate asthma symptoms through hyperventilation, patients’ overuse of as-needed asthma medications, more frequent hospital admissions, and longer hospital stays and with more frequent steroid treatment. All of these are independent of degree of objective pulmonary impairment [13, 14]. Anxiety and panic are known to be associated with bronchial asthma with variety of impact on clinical presentation, treatment outcome, comorbidities, quality of life, and functional disability in patients with asthma. This study aims to explore the pattern of panic symptoms, prevalence and severity of panic disorder (PD), quality of life, and disability in them. Patients with more severe PD and bronchial asthma had more disability
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