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Objective: Asthma is one of the most common chronic diseases with an increasing prevalence, morbidity and mortality. Asthma has long been considered as a psychosomatic phenomenon in which, changes in psychological state or traits play role in its clinic. Studies showed that patients with chronic health problems were vulnerable to over perception of nonspecific symptoms in a situation that affects the disease. In psychosomatic patients, amplification is thought to be forming this over perception symptoms. A study showed that, the complaint of patients with asthma about shortness of breath are not correlated with the spirometric values, but thought to be associated with psychometric values. Due to its early onset of severe findings in asthma clinics, this is expected to affect the structure of personality. Psychobiological theory of personality that has developed by Cloninger is based on the information obtained by the synthesis of neuropharmacological, and neurobehavioral learning studies: contains four temperaments (Novelty-Seeking, Harm-Avoidance, Reward-Dependence, and Persistence) and three character (Self-Directedness, Cooperativeness, and Self-Transcendence) dimensions. One other personality structure evaluated as alexithymia, is defined as the inability to recognize, distinguish and identify emotions, and has a contribution to perceive and interpretation of the emotional state in the clinic of asthma falsely as physical illness. In this study, it is aimed to investigate somatosensory amplification in asthma patients in comparison to normal controls and their relation with alexithymia, temperament and character traits.
Methods: This study has been carried out in Erenkoy Mental and Sureyyapasa Chest Diseases Research and Training Hospital. Consecutively admitted to the outpatient clinic and clinical severity according to GINA criteria identified 58 asthma patients and 49 healthy volunteers were enrolled. The Toronto Alexithymia Scale-20 (TAS-20), Somatosensory Amplification Scale (SSAS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Temperament and Character Inventory (TCI) were applied to participate in the study.
Statistical analysis: Data acquired were analyzed with SPSS 15.0 software. For digital comparison of groups, chi-square test was applied. For mean comparisons, t test was applied. P<0.005 was considered to be significant.
Results: The mean age of the asthma patients was 38.65±11.94 years, 72% of cases were female. The illness duration was found to be 9.82±9.85 years. Considering the severity of the disease in the group 5.1% were severe, 16.9% moderate persistent, 49.2% mild persistent and 28% was rated as mild intermittent. The patient group’s SSAS average score was 33.75±7.2 and significantly more amplified than normal group. TAS total, A and B subscale scores, BDI, BAI scores, Harm-Avoidance, Persistence, Self-Transcendence subscales of the TCI scores correlated positively, C subscale of the TAS scores, Self-Directedness, Cooperativeness subscales of the TCI were found to be negatively associated with the SSAS scores.
Conclusions: Asthmatic patients were found to be amplified more than controls. Asthmatic patients were found to have a positive relationship between the Harm-Avoidance and Persistence of temperament and Self-Transcendence of the character dimension; and negatively associated with Cooperation and Self-Directedness dimensions of character. Amplification was seen to be associated with many dimensions of temperament and character and also associated with depression, anxiety, and alexithymia in multi-relation.