Relations between asthma and psychological distress: an old idea revisited.

Asthma has long been considered a condition in which psychological distress exerts a negative impact. Epidemiological studies confirm that depression and anxiety disorders, amongst the most common psychiatric disorders, occur in higher rates in people with asthma than in the general population. Alterations in the stress axis, immune and autonomic nervous systems appear to be involved in the pathogenesis of each disorder and may contribute to the observed associations between these conditions. Although there is increasing recognition of the importance of treating psychological distress to optimize symptom control in people with asthma, there are few studies examining whether specific treatments for depression or anxiety can improve symptom control in asthma and result in better overall function and outcome.