Psychosocial assets and severity of chronic asthma

Abstract

A quantitative evaluation of psychosocial assets and environmental change was made in a group of 36 asthmatic patients in whom corticosteroids were part of comprehensive, long-term treatment. There were 15 men and 21 women, ranging in age from 19 to 74 years. All patients were maintained at the lowest possible dosage, but only 5 were not on steroids continuously. Psychosocial assets (coping abilities) were evaluated with the Berle Index (BI). This instrument provides quantitative values for psychologic and social items such as social status, medical history other than asthma, factors related to patient's family, interpersonal relationships, past performance, attitudes, and personality structure. The mean amount of daily prednisone or its equivalent was calculated for the year following the psychosocial testing. Patients with low psychosocial assets (BI < 80 per cent) required higher steroid dosage (mean of 15.8 mg. per day) than those with high scores (5.5 mg. per day). The rank order correlation between BI and steroid dose was significant (r s = −0.564, p < 0.001). The Berle scores were not associated with age of onset or duration of the asthma.