Anxiety Disorders in Patients with Bronchial Asthma Depending on the Level of Its Control

The objective: to determine the presence and level of anxiety disorders in patients with bronchial asthma (BA) depending on its control. Materials and methods. 78 patients with persistent BA of mild and moderate severity (average age – 42.7 ± 3.5 years; 35 were men and 43 were women), with uncontrolled BA, mild and moderate exacerbation, who consulted a family doctor were examined. All patients were prescribed therapy according to the Step 3 of treatment. Assessment of external respiratory function was measured by spirometry. The monitor of the disease was determined using by the Asthma Control Test (ACT) and the Asthma Control Questionnaire (ACQ), anxiety and depression levels – by using the Hospital Anxiety and Depression Scale. All studies were performed during the initial visit and after 1 month. Results. During the period of exacerbation of asthma, a high level of subclinical anxiety was found in 73.1% of patients. Uncontrolled BA course was characterized by cough, shortness of breath, a feeling of tightness and wheezing in the chest. After achieving control, the frequency of anxiety disorders significantly decreased (p < 0.05): the normal indices were determined in 75.6% of patients, subclinical anxiety – in 15.4%. The percentage of patients with clinical anxiety remained stable (12.8% and 9.0%). Achie­ving control was accompanied by a decrease in symptoms and a significant increase in post-bronchodilation indicators of forced expiratory volume in the first second, forced vital capacity of the lungs and the Hensler index. Controlled BA in patients was cha­racterized by a high quality of life (ACQ – 0.68 ± 0.01 points) and a high level of control (AСT – 22.4 ± 1.5 points) (p < 0.05). Conclusions. Uncontrolled BA is associated with the development of subclinical anxiety in 73.1% of cases, and clinical anxiety – in 12.8%. Achieving control is accompanied by reduction in anxiety manifestations, normalization of spirometry indicators, absence of daytime and night-time symptoms, and limitation of physical activity.