Personality Variations in Bronchial Asthma

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Abstract
Forty subjects with active, chronic, perennial bronchial asthma were studied from the psychodynamic point of view. Four patients are presented in detail. Simultaneous study of pulmonary function showed a wide variation in physical manifestations, a feature characteristic of bronchial asthma. There was an equally wide variation in personality disturbance. Some degree was present in all our subjects, although there was no single personality "type". Seven transient psychotic-like episodes occurred, 6 of them accompanied by an increase in asthma. Cortisone, though given to more than half our group, did not provoke such reactions. There was no simple reciprocal relationship between asthma and psychosis. Our asthmatics - as may be true of other psychosomatic patients - appeared to range from mildly neurotic individuals, who had mild physical incapacity, to severely disturbed subjects, who had drastic and crippling respiratory illness. To confirm this observation, the over-all maturity of our subjects was gauged on a roughly quantitative scale by 2 psychiatrists, and was compared with independent assessments by 2 internists of the severity of pulmonary disease. There was a high correlation: the more severe the pulmonary disturbance, the more severe the personality disturbance, which had often existed for many years before the development of asthma. We found no patient with asthma of severe degree who did not also have major personality problems. The reverse does not appear to be true. Our interpretation is that asthma is one among many ways in which emotional difficulties manifest themselves.