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Psychosomatic approach to the allergic asthma patients

International Symposium on Psychosomatic Medicine of the Alexander von Humboldt Foundation
RECENT PROGRESS AND CURRENT TRENDS. Cluj, Romania, 27-29 March 2003

Author: Prof. Dr. I.B. Iamandescu

Epidemiological and experimental proofs sustain the intervention of psychic stimuli (psychological stress and conditional reflexes) in the occurrence and evolution of allergic asthma (as main nonspecific triggers, beside allergens). These data suggest some ways of psychological factors' insertion in neurogenic mechanisms of asthma. The action of "primary stress" (life events) increases the bronchial hyper-responsivity but also modifies the patterns of patient's behavior, inclusively his attitude versus therapeutic compliance. The "secondary stress" induced by the illness (asthma attacks and its severe evolution) - represents another factor which enclose a vicious circle of psychological factors' intervention in asthma. The personality traits of the asthmatics represent a "resonance box" to these psychological stimuli, and they are involved in asthmatics' bad quality of life (determined by the discomfort of the disease and the drug's side effects), as well as in their relationship with the allergist, being a main factor for the application of an optimal supportive psychotherapy. All these reasons can be invoked for a reconsideration of the psychological dimensions of the allergic asthma, and are the support for an algorithm of psychosomatic approach in asthmatics. The steps of this approach are as follows:

  1. establishing the psychological factors' role among nonspecific trigger of asthma;
  2. evaluation of the personality traits and biography of asthma patients;
  3. the diagnostic of eventually-added neurotic symptoms;
  4. evaluation of the quality of life, linked to the disease and/or to the management effects;
  5. establishing of the favoring or minimizing features of the asthmatic personality and of his psychosocial insertion, for a good therapeutic compliance;
  6. elaboration of an own allergologic strategy for a simple supportive therapy.
Lacking this psychosomatic approach of allergic asthma patients by their allergist, despite the real possibilities of clinical healing, it is an obvious danger for a large migration of the asthmatics towards the alternative medicine practitioners, who are based, generally, on a more comprehensive (including psychological) approach of their patients.

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