Anxiety, Depression, and Asthma Control: Changes After Standardized Treatment

Joaquín Sastre, Astrid Crespo, Antonio Fernandez-Sanchez, Manuel Rial, Vicente Plaza, F. Callejas González, J. Jiménez López, M. Martínez Riaza, M. Moscardó Orenes, P. Prieto Montaño, M. Torrecillas Toro, C. Andreu Balaguer, M. Antón Girones, C. Baeza Martinez, I. Flores Martín, P. Gonzalez Delgado, M. Martos Calahorro, G. Mediero Carrasco, R. Rodríguez Pacheco, V. Vilella TomásM. Mota Godoy, J. Zapata Yébenes, O. Villarreal Balza De Vallejo, J. Alvarez Fernandez, T. Bazus Gonzalez, G. Castaño De Las Pozas, C. Diaz Donado, S. Díaz Angulo, G. Gala Ortiz, B. Requejo Mañana, R. Blanco Gonzalez, E. Gómez Nieves, J. Marin Torrado, M. Dordal Culla, J. Juanola Pla, R. Lleonart Bellfill, J. Martos Velasco, E. Pinto Nogues, M. Rivera Ortun, P. Rubinstein Aguñin, N. Subira Farre, J. Valldeperas Combas, I. Ansotegui Zubeldia, G. Bernaola Hortigüela, J. Ciruelos Ayuso, G. González Álvarez, M. Herrerias Peña, A. Lahuerta Castro, P. Losada Llorente, P. Marin Martinez, N. Marina Malanda, F. Garcia Gonzalez, T. Peña Miguel, M. Hernandez, S. Jimenez Timon, S. Porcel Carreño, M. Alwakil Olbah, A. Arnedillo Muñoz, J. Chamorro Mohedad, D. Gutierrez Fernandez, A. Letran Camacho, C. Merinas Lopez, M. Millan Gonzalez, S. Niño Bernal, L. Fernandez Pellon, E. Morchon Miguel, F. Ortiz Portal, A. Suárez Rodríguez, M. Modesto Alapont, I. Raducan, M. Salvador Segarra, P. Galindo Bonilla, P. Mata Calderon, M. Mena Rodriguez, R. Lama Martinez, M. Martín Pérez, M. Morales Villarejo, M. Blanco Aparicio, M. Do Muíño Joga, L. Fontan Garcia-Boente, V. García Paz, F. Gonzalez Barcala, R. Nuñez Orjales, C. Rabade Castedo, M. Rico Diaz, A. Moreno Fernandez, S. Aparicio Español, A. Ruiz San Francisco, B. Alcázar Navarrete, L. Cassini Gomez De Cadiz, M. Escribano Rodriguez, J. Florido Lopez, M. Lara Jiménez, J. Lopez Caballero, M. Martínez Ceres, R. Mayorgas Costoya, C. Morales García, M. Rojas Vilchez, A. Romero Ortiz, J. Beitia Mazuecos

Research output: Contribution to journalArticleResearch

16 Citations (Scopus)

Abstract

© 2018 American Academy of Allergy, Asthma & Immunology Background: It has been documented that anxiety and depression are prevalent in patients with asthma and are associated with greater frequency of exacerbations, increased use of health care resources, and poor asthma control. Objective: To examine the association of asthma diagnosis with symptoms of depression/anxiety and asthma control not only at baseline but also over a 6-month period of specialist supervision. Methods: We enrolled 3182 patients with moderate to severe asthma. All were evaluated with spirometry, the Asthma Control Test, and the Hospital Anxiety and Depression Scale at baseline and at 6 months. Treatments were decided by specialists according to published guidelines. Results: At baseline, 24.2% and 12% of the patients were diagnosed with anxiety and depression, respectively, according to the Hospital Anxiety and Depression Scale. After 6 months, anxiety and depression improved, affecting 15.3% and 8.1% of patients, respectively (P <.001); mean FEV1 and asthma control also improved (FEV1 from 81.6% ± 20.9% to 86% ± 20.8%; Asthma Control Test score from 15.8 ± 4.7 to 19.4 ± 4.4; both P <.001). Patients with anxiety and depression used significantly more health care resources and had more exacerbations. A multivariate analysis showed that patients with anxiety, depression, and lower FEV1 (odds ratio, 0.20, 0.34, 0.62, respectively; P <.001) were independently associated with poor asthma control. A multiple linear regression analysis showed that anxiety had a nearly 4-fold greater influence over asthma control than depression (0.326/0.85 = 4.075). Conclusion: Under standardized asthma care and after a specific visit with the specialist, patients present significant improvement in these psychological disorders and exhibit better asthma control and functional parameters.
Original languageEnglish
Pages (from-to)1953-1959
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume6
DOIs
Publication statusPublished - 1 Nov 2018

Keywords

  • Anxiety
  • Asthma
  • Asthma control
  • Asthma exacerbations
  • Depression
  • Health care resources

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