β2-agonist metered dose inhaler overuse : Psychological and demographic profiles

Objective. To identify psychological and demographic correlates of children and adolescents known to overuse β2-agonist metered dose inhalers (β-MDIs). Design. During residential care for severe asthma, demographic and psychological characteristics of 17 children and adolescents known to be β-MDI overusers were compared with 38 asthmatic subjects of similar age without such history. Results. β-MDI overuse occurred among all groups; however, males, minorities, and those from lower socioeconomic groups were overrepresented. Overusers scored significantly lower on standardized IQ tests. Subtests of arithmetic for numeric reasoning, comprehension for understanding of social values, and picture completion for visual attention to detail were also significantly lower in β-MDI overusers, as were reading achievement tests. Testing also revealed tendencies toward dominant, shrewd, and undisciplined personality traits in the overusers. Conclusion. Recognition of these characteristics of children prone to β-MDI overuse will raise the clinician's awareness of this potential. Greater efforts and alternative approaches toward education and treatment of the at-risk patient and family are indicated.