Long-term follow-up investigation of the effects of the biopsychosocial approach (BPSA) to bronchial asthma.

The recent rapid increase in the number of allergic patients is becoming a social problem. Studies of the causes of this phenomenon involve various fields, with much attention focused on finding new antigens in food, air, articles encountered in daily living, etc. Recent studies of psychoneuroimmunology (PNI) also suggest a strong influence of emotions on allergic reactions. The number of allergic patients is increasing in all civilized countries without exception, and the stress prevalent in modern civilized society is related to this increase. Modern allergology does not yet have sufficient countermeasures for such stress states. We applied a biopsychosocial approach (BPSA) to treatment programs for allergic disease, incorporating treatment of physical and psychosocial problems en bloc. We studied the long-term effects of BPSA therapy on 82 patients who were treated for more than 3 months in the hospital and were examined 2 to 3 years after discharge. Results showed that more than 80% of patients maintained improvement and 45% of those with intractable asthma were able to withdraw from steroid hormones. BPSA achieved better results than those with standard medication administered only to the body. Improvements after treatment included physical changes, normalization of MV (microvibration) type, decreased levels of plasma histamine, and normal circadian rhythms of lymphocyte subsets. These changes reflect part of the physical mechanisms by which BPSA improves asthma symptoms. From a psychological view point, the patients' feelings, personal relations, behavior, etc. were changed after BPSA, allowing a new life style and improved QOL. It is important for asthma patients to maintain good overall condition over long periods. After BPSA, 80% of our patients were able to do so. It is difficult for the therapist to approach asthma from different aspects at once, including biological, psychological, and social, so we developed a five-stage program of BPSA therapy and found that this obtained favorable results.