Observations on patterns of subjective symptomatology of acute asthma

In a previous study, a heterogenous group of 100 severe asthma inpatients rated the frequency with which 77 subjective symptoms were associated with their asthma attacks. Analyses of the self report protocols identified 5 reliable and conceptually clear symptom categories describing the subjective experiences during acute episodes of asthma: 2 mood categories, labeled panic fear and irritability; 2 somatic categories, hyperventilation hypocapnia and airway obstruction; and a fatigue symptom category. In the present study, 15 patterns of symptomatology were identified within the same group of asthma inpatients using the procedures of key cluster analysis. Each pattern contains patients showing a similar profile based on the overall scores across the 5 asthma symptom categories. All but 3 of the full supply of 100 patients could be assigned to 1 of the mutually exclusive symptomatology patterns. Those patients within patterns characterized by the reports of the frequent occurrence of symptoms within 1 or both of the mood categories, panic fear or irritability, were prescribed more intensive steroid regimens at discharge than patients reporting less frequent occurrence of these symptoms during asthma attacks. The study indicates that the subjective symptomatology of acute asthma is diverse, yet capable of organization into a set of symptomatology patterns which appear to be related to the response to treatment.