Respiratory Medicine Section, Dipartimento Toraco-Polmonare e Cardiocircolatorio, Università degli Studi di Milano, Ospedale San Paolo, Italy.
Curr Opin Pulm Med. 2011 Jan;17(1):39-44. doi: 10.1097/MCP.0b013e328341005f.
there is growing awareness of the correlation between psychological factors, the course of asthma, and the outcomes of asthma treatment. However, the implications of this correlation are still poorly understood. Here, we review the role of anxiety and depression in asthma with a focus on recent literature.
recent studies suggest an interaction between behavioral, neural, endocrine, and immune processes and suggest that psychological factors play an active role in the genesis of asthma. Notably, the role of chronic stress has been investigated, including the parental psychological state during pregnancy. There is evidence that in patients with asthma, such stress may induce hyporesponsiveness of the hypothalamus-pituitary-adrenal axis, resulting in reduced cortisol secretion.
even though it is generally accepted that anxiety and depression are more common in asthmatic patients and that there is a close correlation between psychological disorders and asthma outcomes, such as poorer control of asthma symptoms, the implications and practical consequences of this link remain weak. New studies are introducing an intriguing model of the links between emotional stress, brain centers, the immune system, and the hypothalamus-pituitary-adrenal axis that is far removed from the original concept of 'asthma nervosa'.
人们越来越意识到心理因素、哮喘病程和哮喘治疗结果之间存在相关性。然而，这种相关性的意义仍未被充分理解。在此，我们重点回顾了焦虑和抑郁在哮喘中的作用，并对最新文献进行了综述。
最近的研究表明，行为、神经、内分泌和免疫过程之间存在相互作用，并表明心理因素在哮喘的发生中起积极作用。值得注意的是，人们研究了慢性应激的作用，包括孕妇在怀孕期间的心理状态。有证据表明，在哮喘患者中，这种应激可能导致下丘脑-垂体-肾上腺轴反应迟钝，导致皮质醇分泌减少。
尽管人们普遍认为焦虑和抑郁在哮喘患者中更为常见，心理障碍与哮喘结果（如哮喘症状控制较差）之间存在密切相关性，但这种关联的意义和实际后果仍然较弱。新的研究提出了一个引人入胜的模型，即情绪应激、大脑中枢、免疫系统和下丘脑-垂体-肾上腺轴之间的联系，这与最初的“哮喘神经症”概念相去甚远。
