Impact of depressive symptoms on adult asthma outcomes

Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California 94117, USA.
Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology (Impact Factor: 2.75). 06/2005; 94(5):566-74. DOI: 10.1016/S1081-1206(10)61135-0
Source: PubMed

ABSTRACT Psychological disorders, including depression, are common in adults with asthma. Although depression is treatable, its impact on longitudinal asthma outcomes is not clear.
To elucidate the impact of depressive symptoms on patient-centered outcomes and emergency health care use in adults with asthma.
We conducted a prospective cohort study of 743 adults with asthma who were recruited after hospitalization for asthma. Depressive symptoms were defined as having a score of 16 or more on the Center for Epidemiologic Studies Depression Scale. We examined the impact of depressive symptoms on patient-centered outcomes (validated severity-of-asthma score, Marks Asthma Quality of Life Questionnaire, and 12-Item Short-Form Health Survey physical component summary score) and on future emergency health care use for asthma ascertained from computerized databases.
The prevalence of depressive symptoms was 18% (95% confidence interval [CI], 15%-21%) among adults with asthma. Depressive symptoms were associated with greater severity-of-asthma scores after controlling for age, sex, race/ ethnicity, educational attainment, and cigarette smoking (mean score increment, 2.6 points; 95% CI, 1.8-3.4 points). Furthermore, depressive symptoms were associated with poorer asthma-specific quality of life (mean score increment, 19.9 points; 95% CI, 17.7-22.1 points) and poorer physical health status (mean score decrement, 3.7 points; 95% CI, 1.5-5.8 points). Depressive symptoms were associated with a greater longitudinal risk of hospitalization for asthma (hazard ratio, 1.34; 95% CI, 0.98-1.84). After controlling for differences in preventive care for asthma, the relationship was stronger (hazard ratio, 1.45; 95% CI, 1.05-2.0).
Depressive symptoms are common in adults with asthma and are associated with poorer health outcomes, including greater asthma severity and risk of hospitalization for asthma.

  • Source
    • "The exact mechanisms for co-morbidity of asthma and depression remains unclear (Katon et al., 2004; Wright, 2005). Depressive symptoms in adults with asthma are associated with poorer health outcomes, including greater asthma severity and risk of hospitalisation for asthma (Eisner et al., 2005). Asthmatics with depression are more likely to be non-compliant with medication than those without, and hence are more likely to present at hospital (Cochrane, 1996; Opolski and Wilson, 2005; Smith et al., 2006). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Previous studies have linked poor mental human health with environmental degradation, but none have assessed additional diseases that may co-exist with these mental disorders. In previous work, depression was found to be associated with a major form of environmental degradation; dryland salinity. However, little is known about diseases co-morbid with depression in this environmental setting. In rural Australia, dryland salinity is a major form of environmental degradation contributing widely to deterioration and non-viability of farmland. Using georeferenced health record data, Bayesian spatial methods were used to determine the relationship between dryland salinity and a range of human health outcomes. Initial modelling found an increased relative risk for asthma, suicide and ischaemic heart disease in relation to dryland salinity (adjusted for Indigenous and socio-economic status). However, in this follow-up study, a further evaluation of the role of co-morbidities in this population revealed that: (i) the presence of depression was consistently linked to residence in areas with high salinity and (ii) the association of asthma, suicide and heart disease with salinity was most likely attributable to the co-morbidity of the conditions with depression. Given the predicted increase in dryland salinity and the elevated relative risk of depression in impacted areas, the relative risk of the co-morbid conditions can be expected to increase in rural areas in the future, further adding to the burden of disease associated with environmental degradation.
    EcoHealth 05/2011; 8(1):82-92. DOI:10.1007/s10393-011-0686-x · 2.27 Impact Factor
  • Source
    • "Unauthorized reproduction of this article is prohibited. et al., 1992; Eisner et al., 2005). Moreover, different antidepressant drugs have shown anti-inflammatory properties (Martelli et al., 1967; Bianchi et al., 1994; Bianchi et al., 1995, 1996; Sawynok et al., 1999; Zhu et al., 2001; Lee et al., 2002; Abdel-Salam et al., 2003; Kast, 2003; Abdel-Salam et al., 2004; Jones et al., 2004) and this effect could be essential in mediating the clinical response of these drugs through a neuroprotective action. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Evidence has accumulated suggesting that major depression is associated with dysfunction of inflammatory mediators. Moreover, antidepressants show an anti-inflammatory action possibly related to their clinical efficacy. An improvement in psychiatric symptoms has been recently reported in patients treated with anti-inflammatory drugs for other indications. These data imply that inflammation may be involved in the pathogenesis of depression and that anti-inflammatory drugs may be used as an adjunctive therapy. The aim of the present study was to evaluate the behavioural effect of the co-administration of acetylsalicylic acid (ASA, 45 mg/kg or 22.5 mg/kg) and fluoxetine (FLX, 5 mg/kg) in the chronic escape deficit model of depression. The chronic escape deficit model is based on the modified reactivity of rats to external stimuli induced by exposure to unavoidable stress and allows evaluation of the capacity of a treatment to revert the condition of escape deficit. In this model, FLX alone needs to be administered for at least 3 weeks to revert this condition. Our results show that combined treatment of fluoxetine and ASA completely reverted the condition of escape deficit by as early as 7 days, the effect being already partially present after 4 days. The effect was maintained after 14 and 21 days of treatment. ASA alone was ineffective at any time tested and the effect of fluoxetine was significant only at 21 days. These results, together with clinical data from preliminary results, suggest that ASA might accelerate the onset of action of selective serotonin reuptake inhibitor antidepressants.
    International Clinical Psychopharmacology 08/2006; 21(4):219-25. DOI:10.1097/00004850-200607000-00004 · 3.10 Impact Factor
Show more