In Brief

Yoga and hypnosis might not cure the wheezing, coughing and restricted airflow of asthma, but those and other targeted psychological interventions might make living with the illness a lot easier.

Paul Lehrer, PhD, of Robert Wood Johnson Medical School, along with colleagues in Seoul, Korea, and at Rutgers University and the University of Texas at El Paso, conducted a review of the last 10 years of research into asthma's behavioral components and possible psychological interventions. They found no evidence that behavior can cause asthma, but abundant research showing how the condition can be mitigated or exacerbated by patient behavior.

Behaviors that affect asthma include avoiding substances that may trigger an attack (dogs, cats and mold, for example), perceiving one's symptoms, seeking prompt medical care when needed and adhering to a medication regimen. In addition, research shows that negative emotions such as panic and depression can affect the respiratory system, in effect bringing on an asthma attack in people with the disease.

There is little research so far on whether stress affects asthma through the immune system, but stress-management techniques can help asthmatics. For instance, in preliminary studies, yoga caused improvement in asthma symptoms, and hypnosis shows promise in improving "quality of life, but not pulmonary function." Biofeedback, the authors say, "produces effects similar to those of relaxation: small but consistent asthma improvement over time, only rarely of clinical significance."

A promising new area of research is in symptom perception, since inaccurate perception can lead to under- or overmedication. The authors also suggest that doctors include smoking-cessation treatment in asthma education, because smoking has a severe negative effect on adults and children with asthma.

--M. GREENGRASS