Psychological characteristics of children with bronchial asthma depending on the level of control and therapeutic strategy

Abstract

The aim of this work – to investigate the psychological peculiarities of children and adolescents with bronchial asthma (BA) depending on the disease severity and therapeutic strategy. Materials and methods. In total, 133 children with BA were examined (mean age 12.2 ± 0.35 years) and divided into three groups. The first group – 28 patients with long-term controlled BA after allergen-specific immunotherapy (ASIT); the second – 60 children with controlled asthma receiving a basic treatment (low-medium doses); the third group – 45 persons with uncontrolled BA. A control group consisted of 30 healthy children. T. Leary test modified version by L. M. Sobchik and Lüscher color test were used. Statistical analysis was performed using program Statistica (version 13.0). Results. The prevalence of certain types of interpersonal relationships was revealed in different groups (χ2 = 152.9; P < 0.01). The first group children demonstrated predominately cooperative, friendly VII (28.6 %) and altruistic VIII (64.3 %) types. Nearly all eight types of interpersonal relationships characterized the second group. Subordinate V and docile dependent VI types dominated in the 3rd group (35.6 % and 60.0 %, respectively) with a tendency to hostility and alienation. Children differed significantly in mother (χ2 = 37.7; P < 0.01) and self-association (χ2 = 111.7; P < 0.01) by the structure of chosen color. The first group patients chose red, green and blue colors, children with BA were characterized by passive behavior without activity and initiative in need of heightened protection and attention. They chose grey and brown (55 % in the 2nd and 80 % in the 3rd group). Choice instability was more typical for the second and third groups (45 % and 51 %, respectively) than for children after ASIT (10.7 %) and healthy children (6.7 %) OR=9.17, CI 95 % 2.1–40.04. Marker of emotional instability was higher in children with uncontrolled BA (53.3 %) than in stable BA (33.3 %; P < 0.05) and after ASIT (7.1 %; P < 0.05). Conclusions. Types of psychological and emotional changes in children with BA depend on the level of disease control as well as on the remission duration. Allergen-specific immunotherapy improves emotional wellbeing of patients with asthma, increases their activity and working ability, improves the level of control. It is recommended to identify a high-risk group for psychological and emotional impairments.

Keywords

• bronchial asthma
• children
• character