Prescription of oral corticosteroids in near-fatal asthma patients: relationship with panic-fear, anxiety and depression.

Oral corticosteroids are the most effective drugs for illness management, especially in near-fatal asthma (NFA) patients. Prescription of oral corticosteroids in other groups of asthmatic patients has been shown to be related not only to clinical features of the illness, but also to psychological variables, what suggests the need to investigate this relationship specifically in NFA patients. Forty-two NFA patients aged 18--83 were interviewed to collect data on sociodemographics, clinical features and psychological variables, specifically panic-fear, anxiety and depression; 45.2% had been prescribed oral corticosteroids and 54.8% had not been prescribed this type of medication. Only frequency and severity of symptoms (odds ratio=3.14; 95% confidence interval=1.27-7.79; p=0.013) and state-anxiety (odds ratio=1.03; 95% confidence interval=1.03-1.29; p=0.015) emerged as significant risk indicators for the prescription of oral corticosteroids. These preliminary results in NFA patients confirm previous reports about the relationship between prescription of oral corticosteroids and psychological variables in asthmatic patients. State-anxiety could increase the magnitude of breathing difficulties, and thus imply the need for more effective medications for its management, but further research is necessary to reject other possible explanations.