Psychosomatic Research on Bronchial Asthma (The First Report) : Chiefly examined by the CAI (Comprehensive Asthma Inventory)

Abstract

Emotional factors often influence bronchial asthma. CMI(Cornell Medical Index-Fukamachi method) has been utilized to assess psychological factors of patients with bronchial asthma.However CMI is one of methods to assess a neurotic tendency of patients but not psychosomatic disease perse. We think it is important to distinguish between neurosis and psychosomatic disease.The Comprehansive Asthma Inventory (CAI) which was originated by the Japanese Society of Psychosomatic Research on Respiratory Disease, is a questionnaire containing 22 questions designed to reveal emotional factors concerned with occurrence of astham attack. Using CAI, we find out psychosomatic disease and neurosis (including depression) in the patients with bronchial asthma. In this study we tried calculating the percentage scores of 9 psychological categories as "extent of conditioning, " "suggestibility, " "expected anxiety, " "dependency, " "frustration, " flight into illness, " "distorted life habits, " "negaitve attitudes towards prognosis, " " decreased motication towards therapy, " and taking average of total percentages (we call it CAI score).We applied five psychological tests (CMI, self-rating Depression Scale, Manifest Anxiety Scale, Yatabe-Guilford test, Seikenshiki Inventory) and CAI to 121 cases with bronchial asthma (50 males, 71 females; ages from 15 to 72,mean 39.8 years old) at the 1st Department of Internal Medicine, Nihon University School of Medicine.The results were summarized as follows;1. Numbers of neurotic cases were 53(43.8%), and that of depressive cases were 21(17.4%).In 28 cases (23.1%), no particular emotional factors were found by five psychological tests, but by the CAI, many emotional factors were found out.2. We devided 47 (38.8%) cases without neurotic or depressive states into two groups by the CAI. There were 14 (11.6%) cases with low-CAI scores, in which the mean CAI score was 9.3. There were 33 (27.3%) cases with high-CAI scores yet without in which the mean CAI score was 26.3.3. The high-CAI gropu with no abnormalities on CMI and SDS, comparing with the low-CAI group, had higher scores in the items as "extent of conditioning, " "suggestibility, " "dependency, " "frustration, " "distorted life habits" (p<0.01), "expected anxiety, " "flight into illness, " "negative attitudes towards prognosis, " "decreased motivation towards therapy" (p<0.05) on the CAI, and thus had higher CAI scores (p<0.01).4. The high-CAI score group without neurotic and depressive states answered "yes" to the questions as "Does your attack always lead you to the same condition? (p<0.01), "Do you often think that your asthma is incurable? (p<0.05) more often than the low-CAI group.