Problemas psicológicos y asma
Resumen
Uno de los tópicos de la investigación sobre asma es su elevada co-ocurrencia con algunas modalidades de trastornos mentales y del comportamiento. Este tópico lo vienen confirmando los estudios epidemiológicos que muestran una prevalencia mayor de trastornos mentales en la población de personas con asma que la que se encuentra en la población general, tanto adultacomo infantil y adolescente. Los trastornos más prevalentes son los de ansiedad, en especial los de pánico y ansiedad generalizada, y los depresivos, con tasas hasta cuatro veces superiores a las de la población general sana. Pero también se han constatado cifras anormalmente elevadas de los trastornos de estrés, especialmente estrés post-traumático, y los relacionados con abuso de sustancias, entre otros. En suma, una gama amplia de psicopatologías cuya importancia en relación con el asma es variable, pero cuya identificación es parte ineludible del tratamiento del asma. Además, algunos estudios constatan que en unos casos el asma precede a las patologías mentales, y en otros sucede a la inversa. El objetivo de esta revisión es ofrecer información actualizada sobre la comorbilidad entre asma y los trastornos mentales mencionados, las razones que se aducen para explicarla, y las consecuencias que tienen para el tratamiento del asma. Tomados en conjunto, los datos procedentes de los estudios revisados indican la posibilidad de una asociación bi-direccional entre asma y trastornos mentales, con algunos mecanismos causales comunes que, de confirmarse, requerirá cambios en los planteamientos terapéuticos cuando sea evidente que existe concurrencia clínicamente significativa entre asma y trastorno mental.
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