Psychosomatic study of inhalation therapy in patients with bronchial asthma. II. Relationship between subjective self assessment of dyspnea and peak expiratory flow rates

The degree of dyspnea when using metered-dose inhalers (MDIs), and the relationship between subjective self assessments and objective peak expiratory flow rates were examined by means of visual analogue scales and mini wright peak flow meters in 16 subjects with asthma. Three subjects who were neurotic in character were found to have a poor perception of the degree of airway obstruction after inhalation compared with objective changes in their condition. Two subjects, one neurotic and one alexithymic, assessed the degree of dyspnea to be worse after inhalation, when objectively there were few changes. However, one neurotic subject perceived an improvement in his condition when, in fact, there was little change. Furthermore, some severe cases used MDIs in the rogressive state of airway obstruction. In conclusion, we must pay attention to patients' characters when determining treatment in order to prevent overuse of MDIs or delays in treatments including the use of MDIs.