Aim. The author examined psychiatrically a group of 106 patients with difficult asthma and 100 patients with aspirin-induced asthma. The special interest of the study were links between defence mechanisms used by women and men from both groups and severity of their panic and depressive symptoms. Methods. 106 consecutive adults with confirmed, physician-diagnosed difficult asthma and 100 patients with aspirin-induced asthma underwent the psychiatric interview and assessment using M.I.N.I 5.0, Beck Depression Inventory (BDI), Panic And Agoraphobia Scale (PAS) and the Defence Style Questionnaire. Psychiatric assessment was performed by an experienced liaison psychiatrist according to ICD-10 and DSM-IV diagnosis. In the difficult asthma group there were 78 women (74%) and 28 men (26%). The average age was 51.3 (SD=14.5) for women and 47.5 (SD=12.7) for men. In the aspirin induced asthma group there were 66 women (66%) and 34 men (34%). The average age was 52.7 (SD=12.3) for women and 48.8 (SD=13.0) for men. Results. In both groups of asthmatic patients women were majority (74% with difficult asthma and 66% with aspirin-induced asthma) with higher level of anxiety and depressive symptoms than men. Generally in difficult asthma group significantly more often than in aspirin-induced asthma neurotic and immature defence mechanisms were used. In both groups, either in women and in men there was a strong tendency to decrease the use of mature defence mechanisms and increase the use of neurotic and immature defence mechanisms in association with an increase of severity of panic and depressive symptoms. Conclusions. It is possible that differences in defence mechanisms used by women and men with difficult asthma affect the development, course and severity of their anxiety and depressive symptoms. This may play a special role in the development of difficult asthma phenomenon.