Links between defence mechanisms and severity of symptoms of panic disorder in women and men with difficult and aspirin-induced asthma

Background. The author examined psychiatrically a group of 106 patients with difficult asthma and 100 patients with aspirin-induced asthma. The special interest of the study were the links between defence mechanisms used by women and men from both groups and severity of their panic symptoms. Methods. 106 consecutive adults with confirmed, physician-diagnosed difficult asthma and 100 patients with aspirin-induced asthma underwent psychiatric interview and assessment using M.I.n.I 5.0, Panic and Agoraphobia Scale (PAS) and Defence Style Questionnaire. Psychiatric assessement was performed by experienced liaison psychiatrist according to ICD-10 and DSM-IV diagnosis. In difficult asthma group there were 78 women (74%) and 28 men (26%). The average age was 51.3 (SD=14.5) for women and 47.5 (SD=12.7) for men. In aspirin induced asthma group there were 66 women (66%) and 34 men (34%). The average age was 52.7 (SD=12.3) for women and 48.8 (SD=13.0) for men. Results. In both groups of asthmatic patients women were in majority (74% with difficult asthma and 66% with aspirin-induced asthma), with higher level of anxiety and depressive symptoms than men. Generally in difficult asthma group significantly more often than in aspirin-induced asthma neurotic and immature defence mechanisms were used. In both groups, both in women and in men, there was strong tendency to decrease the use of mature defence mechanisms and increase the use of neurotic and immature defence mechanisms in association with increase of the severity of panic symptoms. Conclusions. It is possible that differences in defence mechanisms used by women and men with difficult asthma affect the development, course and severity of their anxiety symptoms. This may play a special role in development of difficult asthma phenomenon.