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Careful systematic psychiatric study of forty patients with active chronic non-seasonal bronchial asthma showed that all had obvious emotional problems. The authors agreed with other workers in this field that asthmatics show a wide variety of disturbances with no single personality type. There were seven psychotic reactions in six of the forty subjects. All but one of these coincided with an asthmatic attack, and extensive treatment with ACTH and cortisone did not precipitate the psychotic episodes. From these observations it appears that asthma does not stand in any simple reciprocal relationship to psychosis. All possible relations and lack of relations between asthma and psychosis exist. The authors point out that the most frequent personality disturbance in subjects of all ages was a depressive mood. This was common between attacks, and during them it was almost universal. Among the group hysterical traits and symptoms were often found, and these not only appeared to be alternative or parallel manifestations of tension, but actually seemed to fuse with the asthmatic process in the form of coughing, nasal symptoms, and vocal manifestations. Moreover, the more severe the pulmonary disturbance, the more severe the personality disturbance. Asthma is one among many ways in which emotional difficulties manifest themselves.
These forty patients showed some, but by no means all, of the conflicts found in asthmatics by other investigators. The patients showed various preoccupations: with bodily sensations, with fantasies, with affects, and with problems of communication. The authors' findings are consistent with the hypothesis that the respiratory apparatus in asthmatics has acquired special importance in different ways for different individuals. The data suggest that only a more comprehensive formulation will cover the observed facts. It must account for the predominantly depressive state of asthmatics, marked by intense dependence, masochistic resolution