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Psychosomatic Medicine 19:443-465 (1957)
© 1957 American Psychosomatic Society

Personality Variations in Bronchial Asthma

A Study of Forty Patients: Notes on the Relationship to Psychosis and the Problem of Measuring Maturity

PETER HOBART KNAPP M.D.1 and S. JOSEPH NEMETZ M.D.1

1 Departments of Psychiatry and Medicine of the Boston University School of Medicine, Boston, Mass.

Forty subjects with active, chronic, perennial bronchial asthma were studied from the psychodynamic point of view. 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, six of them accompanied by an increase in asthma. Cortisone, though given to more than half out 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 two psychiatrists, and was compared with independent assessments by two 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.

Submitted on April 25, 1957




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