The impact of panic disorder on severe asthma and chronic rhinosinusitis with nasal polyps: A comparative clinical...

We cross-sectionally compared outpatients with severe asthma (SA), chronic rhinosinusitis with nasal polyps (CRSwNP), or both, grouped by current, past, or absent panic disorder (PD) history, to assess clinical differences. Published data on this topic are limited in SA and absent in CRSwNP.

Between February and March 2024, outpatients at the Personalized Medicine Asthma and Allergy Clinic, Humanitas Research Hospital, were consecutively recruited during follow-up visits. All were previously enrolled in the SANI (Severe Asthma Network Italy) or RINET (Rhinosinusitis Italian Network) registries. Participants completed a self-report survey assessing sociodemographics, lifestyle, medical history, asthma control, nasal obstruction, physical symptoms, cognitive-emotional factors, and quality of life. Provisional diagnoses of PD (PPD) and, additionally, major depressive episode (PMDE) were based on the Patient Health Questionnaire (PHQ). Analyses included Kruskal-Wallis, Dunn's post-hoc, and Fisher's exact tests with Holm's correction (α = 0.05).

Among 79 patients (58.2 % women), 7 (8.9 %) had current PPD and 12 (15.2 %) had past PPD. Four (5.1 %) had a PMDE. PPD significantly correlated with poorer asthma control, more severe nasal obstruction, increased dyspnea and physical symptoms, greater asthma-related catastrophizing, focus on bodily sensations, avoidance of activities, and reduced quality of life.

PPD is more prevalent in SA and/or CRSwNP than in the general population. Panic comorbidity links to greater respiratory severity and symptom burden, supporting screening and integrated care. The study is novel in including CRSwNP, advanced-treatment patients, evaluating current and past PPD, and exploring multiple previously unexamined clinical aspects. Further research is warranted.