IS CHRONIC
INFLAMMATION OF THE RESPIRATORY TRACTS ONLY CAUSE OF ASTHMA?
Zdravko N.
Kadijevic
Pediatric
Service, Medical Center Kotor, Montenegro, Yugoslavia
Introduction: Asthma is the most common
chronic disease in pediatrics. It is believed that the incidence of asthma
among children up to 15 years of age is between 15% and 20 % and is on the
increase. Today asthma has become a worldwide health problem. In 1995 the
World Health Organization and the American National Institute adopted a
"Global Strategy for the Monitoring and Prevention of Asthma".
In order to systematize knowledge and to
coordinate efforts at preventing the further spread of the disease the
European and American "advice on the treatment of Asthma" was
published. This document covers the whole problem of the disease, beginning
with a definition of the condition, and including clinical views, therapy
and education.
In the light of new
understandings of the causes of asthma, the disease is defined as chronic
inflammation of the respiratory tracts. The dominant factor in the onset of
bronchial obstruction is chronic inflammation of the respiratory tracts
whereas the role of psychological factors is almost ignored probably
because of a lack of investigation. According to Pavlov (I. Pavlov
1849-1936) allergic asthma is internal reflex, while asthma brought on
without contact with an allergen is conditional reflex. It is usually
brought on by combination of factors is rarely the only causes of an
asthma attack. It is usually brought on by combination of factors with
allergic and non-allergic causes. As long as 4th century BC Hippocrates
stated "Asthmatics should avoid becoming angry". The importance
of psyhological factors is born out by the facts that in domestic
literature and in the foreign literature that I have not found one case of
pateints with psychoses (schizophrenia, paranoia, etc.) who suffer from
asthma. Cases have been described where asthma patients have become
psychotic and their asthma attacks have ceased.
The purpose of this paper is to point to
the facts that amongst the causes of asthma in some patients the
psychological factor is present.
Our paper and discussion: The examining of
medical recording and a retrospective analysis of the history of 42 asthma
sufferers who were tested from 1974 to 1999 through interviews
and psychological tests. The ages of the patients ranged from 7 to 19.There
were 29 males (69%) and 13 females (31%).
Results: Of the 2 patents, 26 (62%)
suffered from anxiety, psychological stress preceded an attack of asthma in
9 patients (21%), lack of self confidence 15 (36%), high level of
intelligence 26 (62%), average intelligence 13 (31%), bellow average
intelligence 3 (7%). Family situation: stable family environment 26 (62%),
strong attachment to one of the parents - mother 21 (50%), father 17 (40%),
overprotective parents 29 (69%), family conflict 6 (14%), divorced parents
7 (17%) and loss of one of the parent 3 (17%). It is generally known that
asthma sufferers are by the nature people of weaker psychological makeup
who lives in constant fear of suffocation. Immediatly after the last war in
Bosnia I had opportunity of observing and treating four asthma patient
between 16 and 19. Their diagnosis was made before the war- known
children's clinics of the,then, Federal Republic of the Yugoslavia. From
their personal record we can see that during the war, in spite of the
problems caused by the war, our patients did not have attacks of bronchial
obstruction (clinical remission lasted trough the war(. When they returned
to a peaceful life after the war,the same patents once again had attacks of
bronchial obstruction. Fear of death during the war was stronger than the
fear of breathing difficulties and suffocation.
Conclusion : Instead of a conclusion
we will quote Plato's (Plato, 427-347 BC) advice to the doctors of his
time: "the biggest error made by the doctors is when they separate the
soul from the body".