Anxiety, Depression Associated With Poor Self-Perceived Asthma Control

Man with depression, profile
Man with depression, profile
Investigators conducted a prospective survey to examine the association between asthma symptom severity and symptoms of depression and anxiety.

This article is part of Pulmonology Advisor‘s coverage of the American Thoracic Society’s International Conference, taking place in San Diego, California. Our staff will report on medical research related to asthma and other respiratory conditions, conducted by experts in the field. Check back regularly for more news from ATS 2018.

SAN DIEGO — A study has shown that anxiety and depression symptoms are associated with a poorer perception of control over one’s asthma. This research was presented at the American Thoracic Society International Conference, held May 18-23, 2018, in San Diego, California.

Study authors described how psychiatric disorders are rarely addressed during routine clinical questioning in patients with asthma “even though it has been well-documented that the overlap is substantial and may in fact affect symptomatology,” stated lead author Umma Kulsum, MD, from Jamaica Hospital Medical Center in Jamaica, New York.

This prospective study included 62 participants who were 77% female, 13% Caucasian, and who had a mean age of 56 (standard deviation [SD] 15) years. The participants were English-speaking and had been diagnosed with asthma for a minimum of 6 months. Their clinical characteristics and demographics were recorded, and they took the Beck Anxiety Inventory (BAI; scoring 0 to 63 to indicate severity of anxiety symptoms), Asthma Control Test (ACT; scoring 0 to 25 to indicate self-perceived control over asthma), and Patient Health Questionnaire-9 (PHQ9; scoring 0 to 27 to indicate severity of depressive symptoms).

There were correlations between BAI and ACT scores of -.49 (P <.001) and between PHQ9 and ACT scores of -.38 (P =.002). The BAI found 17% of participants scoring for mild to severe anxiety symptoms. The mean score for self-perceived asthma control among the participants was 15.8 (SD 5.2), with 64% scoring below 19 and thus indicating low perceived control over their asthma. Healthcare resource utilization measures did not correlate with ACT scores. PHQ9 scores indicated mild to severe depressive symptoms in 41% of participants, and 22% scored above 10, which suggested clinical depression. Most individuals showing notable anxiety or depression symptoms were not undergoing applicable treatment.

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The study researchers conclude that “[increased] symptoms of anxiety and depression are associated with worse self-perceived asthma control. The relationship between asthma and anxiety has been shown to be bi-directional. Worse asthma control may lead to increased symptoms of anxiety or depression. Anxiety or depression may affect the perception of dyspnea in asthma. Cognitive behavioral therapy has been shown to reduce anxiety and depression in patients with asthma. Attention to psychological symptoms could aid in the treatment of poorly-controlled asthma.”

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Kulsum U, Cervellione K, Ullah T, Jain P, Chester A, Thurm CA. Anxiety, depression, and symptom control in adult patients with asthma. Presented at: American Thoracic Society 2018 International Conference; May 18-23, 2018; San Diego, CA. Abstract 4895.