Introduction: Little is known about health-psychologic features and health-related quality of life (HRQoL) in persons with severe asthma. Hence, the aim was to explore these features among persons with severe asthma.

Methods: In the population-based West Sweden Asthma Study, 68 persons with severe asthma completed questionnaires on HRQoL (SF-8), asthma control (ACT), general self-efficacy (GSE), beliefs about medications (BMQ), anxiety and depression (HADS). Severe asthma was based on GINA treatment steps 4/5. Sub-groups were compared with the Mann-Whitney U test and associations were explored using the Spearman’s r.

Results: Women with severe asthma reported worse mental HRQoL and indicated more symptoms of anxiety on HADS compared to men with severe asthma. Persons with severe asthma and ACT<20 reported worse physical HRQoL and perceived their medication as more necessary than those with severe asthma and ACT≥20. Among persons with severe asthma, physical HRQoL was associated with ACT-score (r=.613, p>.001). Mental HRQoL was associated with symptoms of anxiety (r=-.670, p>.001), depression (r=-.499, p>.001), self-efficacy (r=.344, p=.004) and concerns of asthma medication side effects (r=-.340, p=.006) within the same group.

Conclusions: Health-psychologic features and HRQoL were different between sub groups of severe asthma. Use of questionnaires in asthma management in healthcare might be helpful to identify these sub-groups and provide improved and preventive care.