Особливості психологічних порушень у пацієнтів із тяжкими загостреннями бронхіальної астми в умовах воєнного стану

The potential harm to lung health due to war is difficult to overestimate. An important factor influen­cing the course of bronchial asthma is stress and psychological trauma, as well as an increased risk of anxiety and depression, and a high probability of panic attacks, which exacerbate respiratory symptoms and worsen the response to standard therapy. Objective — to investigate the features of psychological disorders in patients with severe asthma exacerbations in the wartime conditions. Materials and methods. One hundred patients with severe asthma exacerbations were examined, including 40 military personnel and 60 civilians. All 100 patients were surveyed using the following questionnaires: Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ), mMRC Dyspnoea Scale (Modified British Medical Research Council), PHQ-9 (Patient Health Questionnaire — Depression), Beck Anxiety Inventory, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Athens Insomnia Scale (AIS). Results and discussion. The results of the questionnaire analysis showed that all studied patients had uncontrolled asthma and most of them had clinical signs of depression. All patients had anxiety disorders and, on average, a moderate level of sleepiness, as well as poor sleep quality and subthreshold or moderate insomnia. In comparison with civilians, military personnel with severe asthma exacerbations had significantly worse asthma control, a higher degree of dyspnoea, a higher percentage of patients with clinically significant sleepi­ness, and severe insomnia. Among military personnel, there was worse sleep quality — (11.9 ± 0.7) points according to the PSQI, (14.8 ± 1.0) points of the ISI, and (13.9 ± 0.9) points of the AIS compared to civilians — (9.9 ± 0.6), (12.3 ± 0.7), and (11.0 ± 0.7) points, respectively (p < 0.05). Among civilians, the proportion of patients with clinical signs of depression, clinically meaningful anxiety and severe anxiety is significantly higher. Conclusions. The features of psychological disorders in patients with severe asthma exacerbations in the wartime conditions are clinically significant depression, severe anxiety, sleep quality disorders, insomnia, and daytime sleepiness in most patients. Clinicians should consider the potential risk of depression, anxiety, sleep problems in asthma patients, and offer appropriate counselling and interventions to patients.