Relationship of psychopathology to death in asthmatic adolescents.

With the help of three illustrative cases, all of whom died during an acute asthmatic attack, it is proposed that patients with severe psychopathology who also have asthma are particularly susceptible to the more serious complications of asthma. This is related to the circular reactions to anxiety and the patient's incapacity to cope with it. Often these patients are either unusually sensitive to the pharmacological agents used in the medical regime, or they overmedicate themselves. At the same time the reactions of the family and medical staff tend to increase anxiety in these patients. This finally leads to psychological decompensation, making medical treatment extremely difficult. Some therapeutic interventions in dealing with this problem have been suggested. These include the development of an asthma team which can provide supportive psychotherapy to high risk patients.