P137 Loss, shame, lack of control and entrapment are more prominent for severe asthma psychology clients than for people with psychosis plus depression

Abstract

Introduction Beliefs about one’s illness or ‘illness perceptions’ are central to the experience of treatment, engagement with treatment and quality of life (QOL).1 The Personal Beliefs about Illness Questionnaire revised (PBIQ-R)2 is a self-report measure designed to assess the impact of psychosis upon patient’s perception of their social rank, or the value they consider themselves to have compared to others because of their psychosis. Aim To compare illness perceptions in patients with severe asthma presenting to psychology to those with psychosis using the PBIQ-R Method The 20 item PBIQ-R has 5 subscales. The British Psychological Society asthma network considered these subscales to be highly relevant to the severe asthma population. The subscale scores from people in severe asthma psychology were compared to scores of people with psychosis with/without depression from the PBIQ-R reliability and validity data. Patients were recruited from two severe asthma psychology services between June 2017–May 2018. Results Forty sequential patients with confirmed asthma following systematic assessment completed the PBIQ-R in relation to their asthma (mean age: 41, range: 18–65, females: 73%, White British: 70%, Asian: 18%, Black: 5%, Other ethnicity: 7%; 38% were prescribed a maintenance dose of oral corticosteroids). All subscales except for social marginalisation are higher (more problematic) in severe asthma than in those with psychosis, or psychosis plus depression (see table 1). Losses in functioning and future possibilities were highly endorsed, (88% endorsed ‘My illness stops me doing the things I want to do’; 65% ‘my asthma is too brittle/delicate for me to work’ and 60% reported embarrassment because of their asthma). Additionally, 77% reported that their asthma frightens them. Conclusion These results highlight the potential psychological impact of living with severe asthma. Given illness perceptions impact QOL and treatment, routine assessment of illness perceptions may identify suitable patients for psychosocial interventions. References Petrie, KJ, Jago LA, Devcich DA. The role of illness perceptions in patients with medical conditions. Curr Opin Psychiatry2007;20(2):163–7. Birchwood M, Jackson C, Brunet K, Holden J, Barton K. Personal beliefs about illness questionnaire-revised (PBIQ-R): Reliability and validation in a first episode sample. Br J Clin Psychol2012;51(4):448–58.