Anxiety and depression in severe asthma
Stubbs, M. Clark, V. Gibson, P. Yorke, J McDonald, V.
Stubbs, M.
Clark, V.
Gibson, P.
Yorke, J
McDonald, V.
Citations
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Abstract
Introduction/Aim: Symptoms of anxiety and depression are highly
prevalent in people with severe asthma. We aim ed to determine clinical
characteristics associated with co-existing symptoms of anxiety and/or
depression in adults with severe asthma.
Methods: Participants with severe asthma (N=140) were recruited to a
cross-sectional study. Asthma quality-of-life and control were assessed
using the Asthma Quality of Life Questionnaire (AQLQ) and the Asthma
Control Questionnaire. Dyspnoea was assessed using the MMRC scale,
dysfunctional breathing with the Nijmegen Questionnaire and symptoms
with the Hospital Anxiety and De pression Scale (HADS). Clinical charac-
teristics were compared between three subgroups: severe asthma only,
severe asthma with anxiety or depression and, severe asthma with both
(indicated by HADS sub-scores [<8 on both subscales; 8 on one sub-
scale; 8 on both subscales]). Associations of clinical characteristics and
symptoms of anxiety and/or depression were determined using multivari-
ate logistic regression.
Results: Participants were (Mean+/-SD) 59.3+/-14.7 years old, and 62%
female. There were 74 (53%) severe asthma participants without symp-
toms of anxiety or depression, 48 (34%) with symptoms of anxiety or
depression and 18 (13%) with overlapping symptoms. Asthma QoL
impairment was greater in participants with anxiety or depressive symp-
toms (4.5+/-1.3) and overlapping symptoms (4.3+/-1.2), compared to severe
asthma only (5.2+/-1.1, p=0.0005). Asthma control was significantly worse
in the anxiety or depression group (2.7+/-1.1) compared to the overlapping
symptom group (2.6+/-1.0) and severe asthma only (2.0+/-0.9, p=0.001). In
multivariate models, dyspnoea was significantly associated with symp-
toms of anxiety or depression (OR=1.63 [1.02, 2.59]). Dysfunctional
breathing (OR=1.15 [1.04, 1.23]) and obesity (OR=1.17 [1.00, 1.35]) were
significantly associated with symptoms of overlapping anxiety and
depression.
Conclusion: People with severe asthma and anxiety and/or depres-
sive symptoms have poorer HRQoL and asthma control. Dyspnoea, dys-
functional breathing and obesity are associated with these symptoms.
These data support the need for psychological screening as part of multi-
dimensional assessment in severe asthma
Description
Date
2021
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Stubbs M, Clark V, Gibson P, Yorke J, McDonald V. Anxiety and depression in severe asthma. Respirology. 2021;26:130.