Psychosocial morbidity but not clinical control is associated with dysfunctional breathing in moderate and severe asthmatics

Background : Asthmatics have a dysfunctional breathing and are more prone to have high levels of anxiety and depression that are associated with worsening in the clinical control. However, the associations among these outcomes remains unknown. Objective: To investigate the association among dysfunctional breathing, psychosocial morbidity and clinical control in asthmatic patients. Methods: Fifty-one adults with moderate and severe asthma were enrolled and the anxiety levels were evaluated by Hospital anxiety and depression questionnaire (HAD), the clinical control by the asthma control questionnaire (ACQ) and the dysfunctional breathing by changes in chest wall volume and its compartments using the optoelectronic plethysmography. Patients were classified according the presence of anxiety and/or clinical control and the comparison was tested using Student t-test with the significance level set at 5%. Results: 31patients presented symptoms of anxiety (AG, 46±12yrs, BMI=28±5kg/m 2 ) and 20 did not present (NAG, 49±10yrs, BMI=28±4kg/m 2 ). No difference in the clinical control was observed between AG and NAG patients (ACQ, 1.9 (0.6-4.6) vs. 2.1 (0.5-3.8) 95CI%; p>0.05); however, AG patients presented a reduced tidal volume in the chest wall and a shorter inspiratory time (respectively, 358±274 vs. 414±379mL and 1.2±0.3 vs. 1.5±0.5 sec; p Conclusion: Dysfunctional breathing is associated with symptoms of anxiety but not with clinical control in patients with moderate and severe asthma.