Life change, coping ability and chronic intrinsic asthma

Abstract

This study was designed to examine the association between psychosocial assets, environmental change and dosage of adrenocorticosteroids required to control chronic intrinsic asthma. Psychosocial assets were quantified in 36 chronic asthmatics with the use of the Berle Index (BI). Environmental changes were quantified with the Schedule of Recent Experience (SRE), and the results were given in Life Change Units (LCU). The mean amount of daily prednisone, or its equivalent, used by the patients was calculated over a one year period after the psychosocial testing, patients with BI<80 per cent required higher dosage (mean of 15·9 mg/day) than those with BI>80 per cent (5·5 mg/day). There was a negative rank order correlation between the BI scores and the steroid dosage ( r s=0·564, p<0·001). There was no apparent relationship between the numerical value of the SRE and the average steroid dosage. However, with the addition of psychosocial assets (BI) to the evaluation, it was found that: (a) patients with high Berle scores invariably required small doses of steroids (5·5 mg/day) regardless of their LCU and (b) patients with low BI and LCU required significantly higher doses of steroids (mean of 19·6 mg/day) than those with low BI and low LCU (6·7 mg/day) ( p<0·01).