Asthma as a Psychosomatic Disorder: The Causes, Scale of the Problem, and the Association with Alexithymia and Disease Control

Background: While psychological factors may play a significant role in the development and course of asthma, the availability of information on the scale of the problem and the factors associated with psychogenic asthma is limited. The aim of the study was to assess the frequency of coexistence of asthma and other diseases considered to be of psychosomatic origin, to assess the impact of stress and strong emotions on the occurrence of acute exacerbations of asthma, to measure the level of alexithymia in asthmatic patients, and to look for its association with acute exacerbations triggered by stress and strong emotions. The level of alexithymia was also assessed in the context of asthma control. Materials and methods: The study was conducted on a group of 54 patients (75.9% females) with a diagnosis of asthma (mean age: 54.37 ± 14.52 years) at the Independent Public Central Teaching Hospital in Warsaw, Poland. The patients completed a questionnaire composed of the Asthma Control Test, a list of factors that could trigger an acute exacerbation of asthma, and the Toronto Alexithymia Scale (TAS-26; translated into Polish by E. Scigala and T. Maruszewski). The patients were also asked about any co-morbidities that had been diagnosed by other doctors and that might be caused, at least in part, by psychological and behavioural factors, and co-morbidities that might be associated with stress but are characterised by somatic manifestations. The co-morbidities in question were: irritable bowel syndrome, atopic dermatitis, depression, panic disorder, and anorexia nervosa. In the remainder of this paper these disorders are collectively referred to as ‘psychosomatic disorders’. The statistical analysis was performed using SPSS 14.0 PL at the significance level p < 0.05. Non-parametric tests for independent samples were used to test the associations between the qualitative variables. Results: In 50% of the cases, at least one of the following disease entities were identified in the patients carrying the diagnosis of asthma: irritable bowel syndrome (n = 8), atopic dermatitis (n = 7), depression (n = 13), panic disorder (n = 9). Alexithymia was diagnosed in 11 cases (21.6%). The correlation of the level of alexithymia with stress and strong emotions was statistically non-significant (χ² = 0.106, p > 0.05). Stress and/or strong emotions were identified as factors triggering acute exacerbations of asthma in 33 cases (61.1%). Poor, good, and complete asthma control was confirmed in 72.5%, 17.6% and 9.8% of the cases, respectively. No association of asthma control with the occurrence of alexithymia was identified (χ² = 0.358, p > 0.05). No association of asthma control with gender was identified (χ² = 0.605, p > 0.05). Conclusions: The high level of alexithymia in asthmatic patients, the frequent occurrence of disorders considered to be psychosomatic in origin, and the considerable impact of stress and strong emotions on the development of acute exacerbations of the disease confirm that asthma can be considered a psychosomatic disorder.