The psychopathological aspect of bronchial asthma is not limited to an anxiety response. There are also episodes of acute fear at the first developed asthmoid attacks; a combination of both often takes the form of so-called panic disorder with anxious anticipation of seizures. In the development of "panic attacks" in patients with bronchial asthma, the predominant distinguishing feature may be the difficulty of exhalation in a true bronchial asthma, while in functional anxiety-autonomic attacks the inhalation is usually difficult. As they are repeated, the alarming oscillations gradually transform into a persistent subdepressive (destic) state. The literature reports a significant link between various mental disorders and asthma, in particular depression and/or anxiety, with some more reliable data regarding anxiety disorders. However, the nature of this relationship remains largely unclear. Somatogenic asthma with increased exhaustion under normal loads and weakness after another asthmoid attack is increasingly noticeable. Dramatic awareness of the fact of severe somatic disease and its associated limitations modifies the content of affective disorders: anxiety becomes less acute, but along with it or in its place there are elements of melancholy depression with experiences of the impossibility of treatment, «attachment to therapy". The increasing somatogenic asthenia brings a feeling of severe physical ailment, similar to the vitalization of melancholia.

Purpose of the study: To test the hypothesis of a specific relationship between anxiety and depression and bronchial asthma, and to test the hypothesis of the effectiveness of cognitive-behavioral therapy as an additional means of treating bronchial asthma.

Materials and methods: 96 adults were surveyed by means of the main socio-demographic variables (i.e. sex, age, marital status, cohabitation/separate residence and BMI). Subjects with asthma were classified according to GINA and ACT. All subjects underwent structured clinical interviews for the diagnosis of ICD 10.

Results: There was a significant association between asthma and anxiety disorders throughout life (OR 3.03; p = 0.003); no significant association with other psychiatric diagnoses. Moreover, life-long anxiety and current anxiety were associated with levels of asthma severity (p < 0.01 and p = 0.001 depending on age). Asthma predates anxiety in 48% of cases; 52% of cases have anxiety predates asthma, with no significant differences between groups. The risk of asthma, especially severe, uncontrolled form (p < 0.01), was higher in patients with anxiety disorder throughout life (p = 0.003 and p = 0.001 depending on age of onset). Current anxiety increased the risk of asthma and uncontrolled form (p < 0.05). Asthma increased the risk of anxiety disorders throughout life (p = 0.002 and p = 0.018 with age). Intermittent asthma increased the risk of life-long anxiety disorders and ongoing anxiety disorders (p < 0.01).

Conclusions: Anxiety disorders, in particular life-long anxiety disorders, are the only mental disorder that is reliably associated with asthma, with a possible two-way link between anxiety and asthma, each of which may be caused by or result from the other.

Anxiety; Bronchial asthma; Depression; Cognitive-behavioral therapy

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