Risk factors for anxiety in a patient with asthma:
(1) past experiences of dyspnea, choking and/or air hunger
(2) severe asthma that has been difficult to control
(3) concurrent anxiety state or reasons for being anxious
(4) side effects of drug therapy (corticosteroids, beta-adrenergic agents)
(5) feeling little control over the asthma
(6) little or no social support
A patient who has been admitted to the ICU for asthma is at risk for post-traumatic stress disorder (PTSD).
Impact of anxiety disorder on a patient with asthma:
(1) decreased quality of life
(2) self-imposed limits on activities (to avoid certain situations perceived as hazardous)
(3) excessive and unnecessary use of asthma medications, which increases the risk for adverse side effects
Pharmacologic therapy of the anxiety and addressing the patient's fears can significantly improve the patient's life and perception of asthma control. Serotonergic antidepressants and buspirone can be effective without impacting asthma control. Benzodiazepines should be used with caution or avoided because of the risk for respiratory depression.
