The effect of personality disorders on asthma severity and quality of life

Assesment of health related quality of life (HRQL) is increasingly recognized as an important part of the patient care in asthma. We aimed to evaluate the effect of personality disorders (PDs) on HRQL and the severity of disease in asthmatic patients. Ninety seven consecutive patients with asthma and ninety healthy controls were included. All patients completed a Short Form-36 health survey (SF-36) and Structured Clinical Interview Form for DSM-III-R Axis-II Disorders (SCID-II). All SF-36 questionnaire scores of asthmatic patients were significantly lower than the controls. There were statistical differences between the asthma severity and the mean scores of vitality and emotional role difficulties of HRQL's subdomains (p=0.03, p=0.014, respectively). There was a weak but statistically significant correlation between the scores of pain and emotional role difficulties, and forced expiratory volume in 1 second (FEV1) (r=0.27, p=0.007; r=0.24, p=0.01, respectively). When compared to healthy controls, patients with asthma had higher prevalence of PDs (p=0.0001). The most common PDs found in asthmatic patients were obsessive-compulsive and avoidant PDs. HRQL values of asthma patients with PDs were significantly lower than patients without PDs except for the physical functioning subscores on HRQL. We conclude that patients with asthma have higher prevalence of PDs, which is associated with their poor quality of life. A psychiatric evaluation may be beneficial in patients with asthma if a concomitant PD is suspected.