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People With Asthma More Likely to Be Depressed
Date:3/4/2010

Study finds rates of psychological distress twice as high in those with airway disease,,,,

THURSDAY, March 4 (HealthDay News) -- Asthma may affect more than your ability to breathe, it may also make you more prone to developing psychological problems, new research suggests.

People with asthma are more than twice as likely to have depression or anxiety as people who don't have the chronic airway disease, according to a report in the March issue of the journal Chest.

To make matters worse, the study authors found that when rates of serious psychological distress went up, health-related quality-of-life scores went down.

"The prevalence of serious psychological distress was 2.5 times higher among adults with asthma, and as serious psychological distress increased, health-related quality went down. So, asthma makes quality of life worse and serious psychological distress makes quality of life worse, and together they synergistically make quality of life even worse," said study senior author Dr. David Callahan, a medical epidemiologist at the U.S. Centers for Disease Control and Prevention and the U.S. Public Health Service in Atlanta.

Study author Emeka Oraka said these findings may apply to other chronic diseases, such as diabetes, and that serious psychological distress may make it harder for people to manage these diseases properly.

"Any kind of mental distress impedes your ability to manage the disease well, whether it's asthma, diabetes or something else," said Oraka, who's an Oak Ridge Institute for Science and Education fellow at the CDC.

Oraka noted that the findings should raise a red flag for clinicians. "Serious psychological distress is a powerful predictor of quality of life, and even more so in the presence of chronic illness," he said. "Don't disregard the importance of mental health in the quality of life of patients with chronic illness."

For the study, the researchers reviewed data from 186,738 adults who had participated in the U.S. National Health Interview Survey between 2001 and 2007. From this database, they discovered that the rate of asthma was 7 percent.

Among all of the study participants, the average prevalence of serious psychological distress was 3 percent, but in people with asthma, the rate of serious psychological distress was 7.5 percent, the researchers found.

Adults with asthma who had other chronic conditions, a history of smoking or alcohol use, and those with a lower socioeconomic background had a greater risk of having serious psychological distress, according to the study.

Oraka said that the study wasn't able to tease out whether asthma is a cause of serious psychological distress or whether asthma medications may make serious psychological distress more likely, or whether people with serious psychological distress may be more likely to have asthma or to report having asthma.

"This study found an association, but no causation," Oraka said.

Dr. Jennifer Appleyard, chief of allergy and immunology at St. John Hospital and Medical Center in Detroit, said it was troubling to see that "the prevalence of anxiety or mental distress is higher in asthmatics than normal, and this is something we need to look for and try to prevent and address it."

She said the subject definitely warrants further study, and that she would like to see a study that assesses asthma more objectively. In the current study, asthma was identified by the study participants, who were asked if a doctor had ever told them they had asthma, and if they still had asthma.

But, "even if you have mild asthma, it's definitely an anxiety-provoking diagnosis," Appleyard added.

"As with any chronic disease, asthma needs to be managed carefully by the patients, and serious psychological distress can get in the way of people managing their own asthma," explained Callahan. "Clinicians need to ask about psychological symptoms in people with asthma, and they need to treat both psychological distress and asthma."

More information

To read more on asthma and depression, visit the American Academy of Allergy, Asthma & Immunology.



SOURCES: David Callahan, M.D., medical epidemiologist, U.S. Centers for Disease Control and Prevention, captain, U.S. Public Health Service, Atlanta; Emeka Oraka, Oak Ridge Institute for Science and Education fellow, U.S. Centers for Disease Control and Prevention, Atlanta; Jennifer Appleyard, M.D., chief, allergy and immunology, St. John Hospital and Medical Center, Detroit; March 2010, Chest


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