Chest
Original ResearchWhat Is Worse for Asthma Control and Quality of Life: Depressive Disorders, Anxiety Disorders, or Both?
Section snippets
Study Subjects
A total of 504 consecutive adult patients with physician-diagnosed asthma were recruited from the asthma clinic of Hôpital du Sacré-Coeur de Montréal from June 2003 to March 2005. Patients were eligible if they had a primary diagnosis of asthma, were between the ages of 18 and 75 years, and were fluent in either English or French. A total of 1,243 patients presented to the asthma clinic, of whom 1,094 subjects (88%) were screened for inclusion in the study (the remaining 149 subjects had
Sample Characteristics
A total of 504 adult asthma participated in the present study. Participants were 61% female and had a mean ± SD age of 50 ± 14.4 years.
Prevalence of Psychiatric Disorders
A total of 31% of patients (n = 157) met the diagnostic criteria for one or more psychiatric disorders (Table 1). A total of 23% of patients (n = 117) met the diagnostic criteria for one or more ADs, the most common of which was panic disorder (11%; n = 53). A total of 20% of patients (n = 97) met the diagnostic criteria for one or more DDs, the most common of
Discussion
The results of the present study indicate a high rate of both DDs and ADs among adult asthmatics. Compared to point prevalence rates in the general population, rates of both DDs and ADs were at least double those observed in the general population (20% and 23% vs 2 to 9% and 1 to 13%, respectively26, 40). More importantly, results suggest DDs and ADs may exert distinct effects on important measures of asthma morbidity. Our findings revealed that both DDs and ADs were independently associated
Acknowledgment
The authors thank Drs. Catherine Lemière, Dr. Jean-Luc Malo, and Mr. Guillaume Lacoste for their invaluable assistance with data collection.
References (53)
- et al.
Psychological disorder is asthma is associated with poor control and poor adherence to inhaled steroids
Respir Med
(2001) - et al.
Are psychiatric disorders associated with worse asthma control and quality of life in asthma patients?
Respir Med
(2005) - et al.
Asthma and panic attacks
Biol Psychiatry
(1997) - et al.
Asthma and mental disorders in primary care
Gen Hosp Psychiatry
(2003) - et al.
Psychometric properties of the Beck depression inventory: twenty-five years of evaluation
Clin Psychol Rev
(1988) - et al.
Anxiety sensitivity, anxiety frequency and the prediction of fearfulness
Behav Res Ther
(1986) - et al.
Determining a minimal important change in a disease-specific quality of life questionnaire
J Clin Epidemiol
(1994) - et al.
Psychophysiologic reactivity in asthmatic children: a cholinergically mediated confluence of pathways
J Am Acad Child Adolesc Psychiatry
(1994) - et al.
Influence of specific emotional states on autonomic reactivity and pulmonary function in asthmatic children
J Am Acad Child Adolesc Psychiatry
(1997) - et al.
Cytokines and major depression
Prog Neuropsychopharmacol Biol Psychiatry
(2005)
Cytokines, stressors, and clinical depression: augmented adaptation responses underlie depression pathogenesis
Prog Neuropsychopharmacol Biol Psychiatry
Academic examinations significantly impact immune responses, but not lung function, in healthy and well-managed asthmatic adolescents
Brain Behav Immun
Direct and indirect costs of asthma in Canada, 1990
Can Med Assoc J
An economic evaluation of asthma in the United States
N Engl J Med
Global strategy for asthma management and prevention
Can guideline-defined asthma control be achieved? The Gaining Optimal Asthma Control Study
Am J Respir Crit Care Med
Control of asthma in Canada: failure to achieve guideline targets
Can Respir J
Patient factors associated with suboptimal asthma control in Canada: results from the Reality of Asthma Control Study [abstract]
Am J Respir Crit Care Med
Primary care assessment of asthma control: discordance with guideline recommendations [abstract]
Am J Respir Crit Care Med
Development and validation of a questionnaire to measure asthma control
Eur Respir J
Minimal important difference for the asthma control questionnaire
Eur Respir J
The psychological factors associated with poor compliance with treatment in asthma
Eur Respir J
Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence
Arch Intern Med
Cited by (210)
The influence of asthma on neuroinflammation and neurodevelopment: From epidemiology to basic models
2024, Brain, Behavior, and ImmunitySystemic Inflammation in Asthma: What Are the Risks and Impacts Outside the Airway?
2024, Journal of Allergy and Clinical Immunology: In PracticeNonrespiratory Diseases in Adults Without and With Asthma by Age at Asthma Diagnosis
2023, Journal of Allergy and Clinical Immunology: In PracticePersonalized Treatment of Asthma: The Importance of Sex and Gender Differences
2022, Journal of Allergy and Clinical Immunology: In Practice
This study was supported by a fellowship grant from the Canadian Institutes of Health Research (Dr. Lavoie) and a Young Investigators grant from the Auger Foundation of Hôpital du Sacré-Coeur de Montréal.
Dr. Lavoie has been paid professional honorariums from GlaxoSmithkline and Pfizer Canada.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).