The diagnosis of asthma is made difficult by the overlap of asthma symptoms with those of other disorders and by the limitations of the specificity of bronchoprovocation tests and symptoms. The purpose of this study was to assess the utility of demographic, medical, and psychiatric variables in predicting airway hyperresponsiveness defined by methacholine inhalation challenge (MIC) test results among patients presumed to have asthma.
Methods
Sixty-eight patients with clinical diagnoses of asthma underwent MIC and provided information about demographic variables, psychiatric symptoms, and medical utilization related to asthma. Logistic regression was used to identify clinical predictors of positive versus negative MIC results.
Results
Negative MIC results were associated with being older, being a life-long nonsmoker, having better air flow, and with having full or subsyndromal symptoms of social phobia. Among persons with clinical diagnoses of mild-to-moderate asthma, 31% had negative MIC tests. Anxiety symptoms related to social circumstances were powerful predictors of the absence of bronchial hyperresponsiveness.
Conclusions
Anxiety symptoms may be mislabeled as a respiratory condition, leading to unnecessary medical utilization.
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