Specificity of bronchial asthma course and the disease internal structure

Abstract

The correlation between the bronchial asthma development specificity and the disease internal structure features is considered. The study was performed in cooperation with the department for boundary psychological pathology and psychosomatic disorders of the Research Institute for Clinical Psychiatry of the NTsPZ Research Center of the Russian Academy of Medical Sciences.
49 women and 29 men aged from 21 to 65 were examined. All the patients had a verified diagnosis of the bronchial asthma. The disease duration was at least 1 year. The questionnaire contained a wide range of questions covering the peculiarities of a patient perception of his state, his attitude to the social significance of the disease consequences, changes in interpersonal relations resulting from a pathological process and others. The factor analysis of the poll was fulfilled. Five independent factors were distinguished. It is possible to interpret them as the main types (variants) of the disease internal structure. These factors were named as follows: hypernosognosia, ego-distennity, “ possibility of concealment” , “attribution of responsibility” and “shame” . The specific features of bronchial asthma course is classified in three groups with due consideration to the disease internal structure. The first group includes symptoms of the disease corresponding to the impossibility of a self-control of an acute bronchial asthma course. The second groups includes persisting symptoms of the bronchial asthma. These symptoms show not the degree of the disease severity but progradientness of the somatic suffering. The third group combines the repelling (evident to everybody) disease indications. The integral assessment of the bronchial asthma seventy excluding the index of the peak full expiration rate, does not evident of the correiation with the disease internal structure. It is possible to use the given differentiation of the bronc'niai asthma parameters for the forecast of the disease internal structure dynamics. Consequently psychotherapy is possible at a well-time in order to correct the patient’s behavior and the disease perception and to optimize the cooperation between the physician and a patient.