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Lu X, Hu X, Wang L. Causal relationship between irritability and asthma: a bidirectional two-sample Mendelian randomization study. NUCLEOSIDES, NUCLEOTIDES & NUCLEIC ACIDS 2024:1-12. [PMID: 38506573 DOI: 10.1080/15257770.2024.2330594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION Previous studies have suggested a relationship between bad mood and asthma. Therefore, in this study, a two-sample Mendelian randomization (MR) method was used to explore the correlation between irritability and asthma. MATERIAL AND METHODS Relevant instrumental variables (IVs) were extracted from the aggregated data of the genome-wide association studies (GWAS) database. Inverse-variance weighting (IVW) and weighted median (WME) were used for the MR analysis to evaluate the causal relationship between irritability and asthma using odds ratios (ORs) and the corresponding 95% confidence intervals (CIs), respectively. The "leave-one-out" method was used for sensitivity analysis. RESULTS The results of IVW analysis using random-effects models suggested that irritability increased the risk of asthma (OR = 1.954, 95% CI = 1.188-3.214, p = 0.008). The results of WME were consistent with this observation (OR = 1.934, 95% CI = 1.100-3.400, p = 0.021). Additionally, gastroesophageal reflux disease (GERD) might account for approximately 40% of the relationship between irritability and asthma. The sensitivity analysis revealed the stability of the results. CONCLUSION The causal relationship between irritability and asthma was analyzed through MR analysis. Irritability increased the risk of asthma. GERD might play an important mediating role in this relationship.
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Affiliation(s)
- Xiaoying Lu
- Department of Respiratory and Critical Care Medicine, Ziyang Central Hospital, Ziyang, Sichuan, China
| | - Xu Hu
- Department of Respiratory and Critical Care Medicine, Ziyang Central Hospital, Ziyang, Sichuan, China
| | - Ling Wang
- Department of Respiratory and Critical Care Medicine, Ziyang Central Hospital, Ziyang, Sichuan, China
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Ishmael L, Apter A, Busse PJ, Calderon-Candelario R, Carroll JK, Casale T, Celedón JC, Cohen R, Coyne-Beasley T, Cui J, Ericson B, Hernandez P, Kaelber DC, Maher N, Merriman C, Mosnaim G, Nazario S, Phipatanakul W, Pinto-Plata V, Riley I, Shenoy K, Wisnivesky J, Yawn B, Israel E, Cardet JC. Asthma morbidity measures across Black ethnic subgroups. J Allergy Clin Immunol 2024; 153:408-417. [PMID: 38000696 PMCID: PMC10922293 DOI: 10.1016/j.jaci.2023.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/04/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Black adults are disproportionately affected by asthma and are often considered a homogeneous group in research studies despite cultural and ancestral differences. OBJECTIVE We sought to determine if asthma morbidity differs across adults in Black ethnic subgroups. METHODS Adults with moderate-severe asthma were recruited across the continental United States and Puerto Rico for the PREPARE (PeRson EmPowered Asthma RElief) trial. Using self-identifications, we categorized multiethnic Black (ME/B) participants (n = 226) as Black Latinx participants (n = 146) or Caribbean, continental African, or other Black participants (n = 80). African American (AA/B) participants (n = 518) were categorized as Black participants who identified their ethnicity as being American. Baseline characteristics and retrospective asthma morbidity measures (self-reported exacerbations requiring systemic corticosteroids [SCs], emergency department/urgent care [ED/UC] visits, hospitalizations) were compared across subgroups using multivariable regression. RESULTS Compared with AA/B participants, ME/B participants were more likely to be younger, residing in the US Northeast, and Spanish speaking and to have lower body mass index, health literacy, and <1 comorbidity, but higher blood eosinophil counts. In a multivariable analysis, ME/B participants were significantly more likely to have ED/UC visits (incidence rate ratio [IRR] = 1.34, 95% CI = 1.04-1.72) and SC use (IRR = 1.27, 95% CI = 1.00-1.62) for asthma than AA/B participants. Of the ME/B subgroups, Puerto Rican Black Latinx participants (n = 120) were significantly more likely to have ED/UC visits (IRR = 1.64, 95% CI = 1.22-2.21) and SC use for asthma (IRR = 1.43, 95% CI = 1.06-1.92) than AA/B participants. There were no significant differences in hospitalizations for asthma among subgroups. CONCLUSIONS ME/B adults, specifically Puerto Rican Black Latinx adults, have higher risk of ED/UC visits and SC use for asthma than other Black subgroups.
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Affiliation(s)
- Leah Ishmael
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Fla
| | - Andrea Apter
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Paula J Busse
- Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Jennifer K Carroll
- American Academy of Family Physicians National Research Network, Leawood, Kan; Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colo
| | - Thomas Casale
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Fla
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, University of Pittsburgh, Pittsburgh, Pa
| | - Rubin Cohen
- Division of Pulmonary Critical Care and Sleep Medicine, Syracuse VA Medical Center, SUNY Upstate Medical University, Syracuse, NY
| | - Tamera Coyne-Beasley
- Department of Adolescent Medicine, University of North Carolina, Chapel Hill, NC
| | - Jing Cui
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, Mass
| | - Brianna Ericson
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Paulina Hernandez
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Mass
| | - David C Kaelber
- Center for Clinical Informatics Research and Education, MetroHealth System, Cleveland, Ohio; Departments of Medicine, Pediatrics, and Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Nancy Maher
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Conner Merriman
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Fla
| | - Giselle Mosnaim
- Division of Allergy, Asthma, and Immunology, Northshore University Health System, Evanston, Ill
| | - Sylvette Nazario
- Allergy and Immunology Section, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Wanda Phipatanakul
- Departments of Allergy and Immunology and Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Victor Pinto-Plata
- Division of Pulmonary and Critical Care, Lahey Hospital and Medical Center, Burlington, Mass
| | - Isaretta Riley
- Division of Pulmonary and Critical Care Medicine, Duke University School of Medicine, Durham, NC
| | - Kartik Shenoy
- Temple Lung Center, Lewis Katz School of Medicine at Temple University, Philadelphia, Pa
| | - Juan Wisnivesky
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Barbara Yawn
- Department of Family and Community Health, University of Minnesota, Minneapolis, Minn
| | - Elliot Israel
- Divisions of Pulmonary and Critical Care Medicine and Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Mass
| | - Juan Carlos Cardet
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Fla.
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Bi-directional associations between depressive symptoms and asthma in middle-aged and elderly adults in China. J Affect Disord 2022; 314:117-123. [PMID: 35835314 DOI: 10.1016/j.jad.2022.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/09/2022] [Accepted: 07/08/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND There is currently no evidence of an association between depressive symptoms and asthma among older adults in China. We explored the bi-directional associations between depressive symptoms and asthma, and their changes in middle-aged and elderly adults from a national cohort. METHODS A longitudinal cohort study was conducted with a total of 17,708 individuals from 150 urban communities and 450 rural villages in 28 provinces in China. RESULTS After making exclusions, 11,492 and 8604 participants were included for incident asthma and incident depressive symptoms analysis, respectively. The incidence density was 4.46 and 10.24 for every 1000 person-years, respectively. Baseline depressive symptoms were associated with a higher risk of incident asthma (Hazard ratio [HR] = 1.60, 95 % confidence interval [CI]: 1.27, 2.02). Decreased depressive symptoms during baseline or follow-ups or both baseline and follow-ups were associated with a lower risk of incident asthma (Pfor trend < 0.0001). Every 1-score increment of CES-D score was associated with a 4 % increase in asthma, with a non-linear association (P = 0.04) between CES-D score (break point = 7) and asthma. Asthma status increased the risk of participants with severe depressive symptoms (HR = 1.51, 95 % CI: 1.19, 1.92), especially in males (Pfor interaction = 0.02). LIMITATIONS Depressive symptoms and asthma were assessed by validated questionnaires instead of clinical diagnosis. CONCLUSIONS Bi-directional associations between asthma and depressive symptoms do exist. Effective measures should be taken to reduce depressive symptoms and the risk of incident asthma in middle aged and elderly adults in China.
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Qiao Y, Liu S, Zhang Y, Wu Y, Shen Y, Ke C. Bidirectional association between depression and multimorbidity in middle-aged and elderly Chinese adults: a longitudinal cohort study. Aging Ment Health 2022; 26:784-790. [PMID: 33512250 DOI: 10.1080/13607863.2021.1877609] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Few studies have investigated the bidirectional association between depression and multimorbidity from a longitudinal perspective. We aimed to explore the bidirectional relationship between depression and multimorbidity in a middle-aged and elderly Chinese population. METHODS Participants aged 45 years and older from the China Health and Retirement Longitudinal Study (CHARLS) were included. Depression was measured with a 10-item version of the Center for Epidemiological Studies Depression Scale (CESD-10). In stage I, we assessed the association of baseline depression with follow-up multimorbidity. In stage II, we examined whether multimorbidity increases the risk of depression. Logistic regression models were used to estimate the odds ratios (ORs) and confidence intervals (CIs). The ORs were then converted to risk ratios (RRs) using a proposed formula. RESULTS A total of 7056 subjects without multimorbidity and 7587 subjects without depression at baseline were included in stage I and stage II. In stage I, the adjusted RRs (95% CIs) of depressed participants developing one disease, two diseases, three diseases, and ≥4 diseases were 1.15 (0.96-1.35), 1.64 (1.36-1.99), 1.84 (1.44-2.35) and 2.42 (1.75-3.34), respectively. In stage II, compared with individuals without any disease, the adjusted RRs (95% CIs) of developing depression for individuals carrying one disease, two diseases, three diseases, and ≥4 diseases were 1.08 (0.96-1.22), 1.39 (1.22-1.57), 1.46 (1.23-1.70) and 1.62 (1.34-1.93), respectively. CONCLUSIONS Baseline depression increases the risk of future multimorbidity, and multimorbidity also contributes to an increased risk of incident depression in middle-aged and elderly Chinese adults.
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Affiliation(s)
- Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Siyuan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yuxia Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Ying Wu
- Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
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Liu L, Luo C, Zhang M, Ao X, Liu H, Peng S. Relationship between allergic diseases and mental disorders in women: A systematic review and meta-analysis. Front Psychiatry 2022; 13:1026032. [PMID: 36440392 PMCID: PMC9682190 DOI: 10.3389/fpsyt.2022.1026032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/19/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The relationship between allergic diseases (AD) and mental disorders (MD) in women has not been fully systematically evaluated. We aimed at validating this correlation. METHODS The relevant cohort and case-control studies from the establishment of the database to February 18, 2022 in PubMed, Embase, and Cochrane library were searched by computer. The researchers conducted the quality evaluation of the included articles by reviewing and discussing with reference to relevant standards, and conducted the analysis of the correlation between female patients with AD and MD by using Review Manager 5.4. RESULTS Six observational studies from 2631 studies (n = 1160858 women) were assessed as medium and high-quality studies. The meta-analysis demonstrated that AD was correlated with MD in female patients (OR = 1.21, 95%CI: 1.14-1.29), including asthma (OR = 1.16, 95%CI: 1.11-1.22), allergic rhinitis (OR = 1.31, 95%CI: 1.06-1.63), and atopic dermatitis in women (OR = 1.37, 95%CI: 1.24-1.50) were associated with MD. At the same time, subgroup analysis was performed according to region, study design, criteria of AD and MD, and the results demonstrated that both AD and MD were correlated in these different conditions. CONCLUSION Allergic diseases in female patients do have an association with mental disorders. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022311146].
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Affiliation(s)
- Lisha Liu
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chao Luo
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Mengni Zhang
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xudong Ao
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huixia Liu
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shunlin Peng
- Department of Otolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Choi HG, Kim JH, Park JY, Hwang YI, Jang SH, Jung KS. Association Between Asthma and Depression: A National Cohort Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 7:1239-1245.e1. [PMID: 30423450 DOI: 10.1016/j.jaip.2018.10.046] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 10/25/2018] [Accepted: 10/29/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Patients with asthma often suffer from depression and vice versa. However, the temporal relationship between the 2 diseases has remained elusive. OBJECTIVE The aim of this study was to determine the bidirectional relationship between asthma and depression in adults, using national cohort samples in Korea. METHODS Using the national cohort from the study by the Korean Health Insurance Review and Assessment Service, patients with asthma and control participants were selected and matched by age group, sex, income group, region of residence, and medical histories. A stratified Cox proportional hazards model was used to analyze the hazard ratio (HR) of asthma with depression (study 1) and depression with asthma (study 2). RESULTS In study 1, the HR of depressive disorders was significantly higher in patients with asthma than in patients without asthma (HR, 1.35; 95% CI, 1.31-1.40). In study 2, the HR of asthma in patients with depression was significantly higher than that in patients without depression (HR, 1.25; 95% CI, 1.21-1.29). CONCLUSION A bidirectional association between asthma and depression was observed in this study.
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Affiliation(s)
- Hyo Geun Choi
- Departments of Otorhinolaryngology-Head & Neck Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
| | - Ji-Young Park
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Yong Il Hwang
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Seung Hun Jang
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Ki-Suck Jung
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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Khan MR, El-Bassel N, Golin CE, Scheidell JD, Adimora AA, Coatsworth AM, Hu H, Judon-Monk S, Medina KP, Wohl DA. The Committed Intimate Partnerships of Incarcerated African-American Men: Implications for Sexual HIV Transmission Risk and Prevention Opportunities. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2173-2185. [PMID: 28332036 PMCID: PMC5911944 DOI: 10.1007/s10508-016-0916-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 11/10/2016] [Accepted: 12/03/2016] [Indexed: 06/06/2023]
Abstract
Incarceration is thought to influence HIV transmission by disrupting partnerships that provide support and protect against sex risk-taking. Current correctional facility-based family-strengthening programs focus on marital partnerships, a minority of inmates' partnerships. Research on the sex partnerships of incarcerated African-American men and the types of partnerships most likely to protect against HIV-related sex risk is limited. Improved understanding can inform expansion of correctional facility-based family-strengthening programs to a greater proportion of protective partnerships and HIV risk reduction programs to partnerships vulnerable to sex risk. Project DISRUPT is a cohort study of African-American men being released from prison in North Carolina who were in committed heterosexual partnerships at prison entry. Using baseline survey data (N = 189), we conducted latent class analysis (LCA) to identify subgroups of participants with distinct relationship profiles and measured associations between relationship characteristics and multiple partnerships of inmates and their partners in the six months before incarceration. LCA indicated a two-class solution, with relationships distinguished by satisfaction/stability (satisfied/stable class: 58.0%; dissatisfied/unstable class: 42.0%); each class had comparable relationship length and levels of marriage and cohabitation. Dissatisfied/unstable relationships were associated with multiple partnerships among participants (AOR 2.93, 95% CI 1.50, 5.72) and partners (AOR 4.95, 95% CI 1.68, 14.58). Satisfaction indicators-versus length, marriage, or cohabitation-were the strongest independent correlates of inmates' and partners' multiple partnerships. Pre-incarceration economic deprivation, mental disorder symptoms, substance use, and violence in relationships were associated with dissatisfaction/instability. Prison-based programs designed to maintain healthy partnerships, strengthen relationship skills, and reduce HIV risk-taking and violence in relationships are warranted and should be targeted to both marital and nonmarital partnerships. Programming also should address the poverty, mental illness, and substance use factors that threaten relationship satisfaction/stability and increase HIV risk.
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Affiliation(s)
- Maria R Khan
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA.
| | - Nabila El-Bassel
- Social Intervention Group, Columbia University, New York, NY, USA
| | - Carol E Golin
- Division of General Internal Medicine and Epidemiology, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joy D Scheidell
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University School of Medicine, 227 East 30th Street, New York, NY, 10016, USA
| | - Adaora A Adimora
- Division of Infectious Disease, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ashley M Coatsworth
- Department of Epidemiology, University of Florida College of Public Health and Health Professions, College of Medicine, Gainesville, FL, USA
| | - Hui Hu
- Department of Epidemiology, University of Florida College of Public Health and Health Professions, College of Medicine, Gainesville, FL, USA
| | - Selena Judon-Monk
- Division of Infectious Disease, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Katie P Medina
- Division of Infectious Disease, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - David A Wohl
- Division of Infectious Disease, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
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HIV-Related Sexual Risk among African American Men Preceding Incarceration: Associations with Support from Significant Others, Family, and Friends. J Urban Health 2017; 94:136-148. [PMID: 28116586 PMCID: PMC5359176 DOI: 10.1007/s11524-016-0120-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We evaluated the association between social support received from significant others, family, and friends and HIV-related sexual risk behaviors among African American men involved in the criminal justice system. Project DISRUPT is a cohort study among African American men released from prison in North Carolina (N = 189). During the baseline (in-prison) survey, we assessed the amount of support men perceived they had received from significant others, family, and friends. We measured associations between low support from each source (<median value) and participants' sex risk in the 6 months before incarceration. Low levels of social support from significant others, family, or friends were associated with poverty and homelessness, mental disorders, and substance use. Adjusting for age, poverty, and other sources of support, perceiving low support from significant others was strongly associated with multiple partnerships (fully adjusted odds ratio (OR) 2.64, 95% confidence interval (CI) 1.29-5.42). Low significant other support also was strongly associated with sex trade involvement when adjusting for age and poverty status (adjusted OR 3.51, 95% CI 1.25-9.85) but further adjustment for low family and friend support weakened the association (fully adjusted OR 2.81, 95% CI 0.92-8.55). Significant other support was not associated with other sex risk outcomes including concurrent partnerships, anal sex, or sex with an STI/HIV-infected partner. Low family support was associated with multiple partnerships in analyses adjusting for age and poverty (adjusted OR 1.98, 95% CI 1.05-3.76) but the association weakened and was no longer significant after adjusting for other sources of support (fully adjusted OR 1.40, 95% CI 0.65-3.00); family support was not correlated with other risk behaviors. Friend support was not significantly associated with sex risk outcomes. Indicators of overall support from any source were not associated with sex risk outcomes. Helping inmates maintain ties may improve economic security and well-being during community re-entry, while supporting and strengthening relationships with a significant other in particular may help reduce sex risk. Studies should evaluate the protective effects of distinct support sources to avoid masking effects of support and to best understand the influence of social support on health.
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Fluharty M, Taylor AE, Grabski M, Munafò MR. The Association of Cigarette Smoking With Depression and Anxiety: A Systematic Review. Nicotine Tob Res 2017; 19:3-13. [PMID: 27199385 PMCID: PMC5157710 DOI: 10.1093/ntr/ntw140] [Citation(s) in RCA: 616] [Impact Index Per Article: 88.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 05/13/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Many studies report a positive association between smoking and mental illness. However, the literature remains mixed regarding the direction of this association. We therefore conducted a systematic review evaluating the association of smoking and depression and/or anxiety in longitudinal studies. METHODS Studies were identified by searching PubMed, Scopus, and Web of Science and were included if they: (1) used human participants, (2) were longitudinal, (3) reported primary data, (4) had smoking as an exposure and depression and/or anxiety as an outcome, or (5) had depression and/or anxiety as the exposure and smoking as an outcome. RESULTS Outcomes from 148 studies were categorized into: smoking onset, smoking status, smoking heaviness, tobacco dependence, and smoking trajectory. The results for each category varied substantially, with evidence for positive associations in both directions (smoking to later mental health and mental health to later smoking) as well as null findings. Overall, nearly half the studies reported that baseline depression/anxiety was associated with some type of later smoking behavior, while over a third found evidence that a smoking exposure was associated with later depression/anxiety. However, there were few studies directly supporting a bidirectional model of smoking and anxiety, and very few studies reporting null results. CONCLUSIONS The literature on the prospective association between smoking and depression and anxiety is inconsistent in terms of the direction of association most strongly supported. This suggests the need for future studies that employ different methodologies, such as Mendelian randomization (MR), which will allow us to draw stronger causal inferences. IMPLICATIONS We systematically reviewed longitudinal studies on the association of different aspects of smoking behavior with depression and anxiety. The results varied considerably, with evidence for smoking both associated with subsequent depression and anxiety, and vice versa. Few studies supported a bidirectional relationship, or reported null results, and no clear patterns by gender, ethnicity, clinical status, length to follow-up, or diagnostic test. Suggesting that despite advantages of longitudinal studies, they cannot alone provide strong evidence of causality. Therefore, future studies investigating this association should employ different methods allowing for stronger causal inferences to be made, such as MR.
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Affiliation(s)
- Meg Fluharty
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom;
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
| | - Amy E Taylor
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
| | - Meryem Grabski
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
| | - Marcus R Munafò
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
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10
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Coogan PF, Castro-Webb N, Yu J, O'Connor GT, Palmer JR, Rosenberg L. Neighborhood and Individual Socioeconomic Status and Asthma Incidence in African American Women. Ethn Dis 2016; 26:113-22. [PMID: 26843804 DOI: 10.18865/ed.26.1.113] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Individual socioeconomic status (SES) has been associated with asthma incidence but whether neighborhood SES has an influence is unknown. We assessed the contributions of neighborhood socioeconomic status (SES), neighborhood housing density, neighborhood racial composition, and individual SES to the development of adult-onset asthma in Black women, accounting for other known or suspected risk factors. DESIGN AND PARTICIPANTS Prospective cohort study conducted among 47,779 African American women followed with biennial health questionnaires from 1995 to 2011. METHODS AND MAIN OUTCOME MEASURES Incident asthma was defined as new self-report of doctor-diagnosed asthma with concurrent use of asthma medication. We assessed neighborhood SES, indicated by census variables representing income, education, and wealth, and housing density and % African American population, as well as individual SES, indicated by highest education of participant/spouse. Cox proportional hazards models were used to derive multivariable hazard ratios (HRs) and 95% CIs for the association of individual SES and neighborhood variables with asthma incidence. RESULTS During a 16-year follow-up period, 1520 women reported incident asthma. Neighborhood factors were not associated with asthma incidence after control for individual SES, body mass index, and other factors. Compared with college graduates, the multivariable HR for asthma was 1.13 (95% CI 1.00-1.28) for women with some college education and 1.23 (95% CI 1.05-1.44) for women with no more than a high school education. CONCLUSIONS Individual SES, but not neighborhood SES or other neighborhood factors, was associated with the incidence of adult-onset asthma in this population of African American women.
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Affiliation(s)
| | | | - Jeffrey Yu
- Boston University, Slone Epidemiology Center
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Depression, Asthma, and Bronchodilator Response in a Nationwide Study of US Adults. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2015; 4:68-73.e1. [PMID: 26563676 DOI: 10.1016/j.jaip.2015.10.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 09/23/2015] [Accepted: 10/08/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Little is known about the relation between 2 common comorbidities (depression and anxiety) and asthma or bronchodilator response (BDR). OBJECTIVE To examine the association between depressive symptoms and asthma or BDR in US adults. METHODS Cross-sectional study of 20,272 adults aged 20 to 79 years from the 2007-2012 National Health and Nutrition Examination Survey. Depressive symptoms were measured using the 9-item Patient Health Questionnaire, and classified as none to minimal, mild, moderate, moderately severe, and severe. Major depression (comprising moderately severe to severe symptoms) was defined as a 9-item Patient Health Questionnaire score of 15 or more. Anxiety was defined as 5 or more days feeling anxious in the previous month. Current asthma was defined as having been diagnosed with asthma by a doctor or health professional and 1 or more asthma attack in the previous year. BDR (as percentage of baseline FEV1) was measured in 1356 participants with FEV1/forced vital capacity of less than 0.70 and/or FEV1 less than 70% of predicted. Logistic or linear regression was used for the multivariable analysis. RESULTS Depressive symptoms were significantly and linearly associated with asthma, independently of anxiety symptoms. Subjects with major depression had 3.4 times higher odds of asthma than did those with minimal or no depressive symptoms (95% CI, 2.6-4.5; P < .01). Among adults with asthma, major depression was associated with a 4.2% reduction in BDR (95% CI, -7.5% to -0.8%; P = .02). Major depression was not associated with BDR among adults without asthma. Anxiety was not associated with asthma or BDR. CONCLUSIONS Depressive symptoms are associated with asthma in adults, independently of anxiety symptoms. Major depression is associated with reduced BDR in adults with asthma.
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Ciprandi G, Schiavetti I, Rindone E, Ricciardolo FLM. The impact of anxiety and depression on outpatients with asthma. Ann Allergy Asthma Immunol 2015; 115:408-14. [PMID: 26392047 DOI: 10.1016/j.anai.2015.08.007] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/03/2015] [Accepted: 08/12/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Anxiety and depression may frequently affect patients with asthma. However, the findings of several studies are partially conflicting and conducted in selected cohorts. OBJECTIVE To investigate the effect of anxiety and depression in a group of outpatients with asthma. METHODS This cross-sectional, real-life study included 263 patients (109 males; mean age, 39.2 years) with asthma. Clinical examination, lung function, fractional exhaled nitric oxide measurement, Asthma Control Test (ACT) score, asthma control grade, perception of symptoms by visual analog scale, and Hospital Anxiety and Depression Scale (HADS) questionnaires were evaluated. RESULTS Globally, 97 patients (36.9%) had anxiety, and 29 (11%) had depression. Of these patients, 71 had combined anxiety and depression. Anxiety and depression were associated with poor asthma control (P =.007 and .02, respectively). Patients with depression had higher body mass indexes (P =.002). Anxiety and depression were associated with lower ACT scores (P < .001 for both). The scores on the anxiety and depression subscales of HADS were moderately related (r = 0.57). CONCLUSIONS The present real-life study indicates that anxiety and depression are common and relevant comorbidities in asthmatic outpatients and are associated with uncontrolled asthma and lower ACT scores. Thus, assessment of comorbid mental disorders should be performed in common practice.
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Affiliation(s)
- Giorgio Ciprandi
- Department of Medicine, IRCCS - Azienda Ospedaliera Universitaria San Martino, Genoa, Italy.
| | | | - Elena Rindone
- Division of Respiratory Disease, Department of Clinical and Biological Sciences, University of Torino, Turin, Italy
| | - Fabio L M Ricciardolo
- Division of Respiratory Disease, Department of Clinical and Biological Sciences, University of Torino, Turin, Italy
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Gao YH, Zhao HS, Zhang FR, Gao Y, Shen P, Chen RC, Zhang GJ. The Relationship between Depression and Asthma: A Meta-Analysis of Prospective Studies. PLoS One 2015. [PMID: 26197472 PMCID: PMC4510436 DOI: 10.1371/journal.pone.0132424] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background Previous studies have suggested that asthmatic patients often have comorbid depression; however, temporal associations remain unclear. Objectives To determine whether depression predicts asthma and, conversely, whether asthma predicts depression. Methods A literature search was conducted without language restrictions using Pubmed, Embase, Cochrane and PsycINFO for studies published before January, 2015. Papers referenced by the obtained articles were also reviewed. Only comparative prospective studies with reported risk estimates of the association between depression and asthma were included. In order to investigate whether one of these conditions was predictive of the other, studies were excluded if enrolled participants had pre-existing depression or asthma. A random-effects model was used to calculate the pooled risk estimates for two outcomes: depression predicting asthma and asthma predicting depression. Results Seven citations, derived from 8 cohort studies, met our inclusion criteria. Of these, six studies reported that depression predicted incident adult-onset asthma, including 83684 participants and 2334 incident cases followed for 8 to 20 years. Conversely, two studies reported that asthma predicted incident depression. These studies involved 25566 participants and 2655 incident cases followed for 10 and 20 years, respectively. The pooled adjusted relative risks (RRs) of acquiring asthma associated with baseline depression was 1.43 (95% CI, 1.28–1.61) (P<0.001). The adjusted RRs for acquiring depression associated with baseline asthma was 1.23 (95% CI, 0.72–2.10) (P = 0.45). Conclusions Depression was associated with a 43% increased risk of developing adult-onset asthma. However, asthma did not increase the risk of depression based on limited studies. Further prospective studies ascertaining the true association between asthma and subsequent risk of depression are warranted.
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Affiliation(s)
- Yong-hua Gao
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Hua-si Zhao
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Fu-rui Zhang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yang Gao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Pamela Shen
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Rong-chang Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- * E-mail: (GJZ); (RCC)
| | - Guo-jun Zhang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- * E-mail: (GJZ); (RCC)
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Lewis TT, Cogburn CD, Williams DR. Self-reported experiences of discrimination and health: scientific advances, ongoing controversies, and emerging issues. Annu Rev Clin Psychol 2015; 11:407-40. [PMID: 25581238 DOI: 10.1146/annurev-clinpsy-032814-112728] [Citation(s) in RCA: 542] [Impact Index Per Article: 60.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Over the past two decades, research examining the impact of self-reported experiences of discrimination on mental and physical health has increased dramatically. Studies have found consistent associations between exposure to discrimination and a wide range of Diagnostic and Statistical Manual of Mental Disorders (DSM)-diagnosed mental disorders as well as objective physical health outcomes. Associations are seen in cross-sectional as well as longitudinal studies and persist even after adjustment for confounding variables, including personality characteristics and other threats to validity. However, controversies remain, particularly around the best approach to measuring experiences of discrimination, the significance of racial/ethnic discrimination versus overall mistreatment, the need to account for "intersectionalities," and the importance of comprehensive assessments. These issues are discussed in detail, along with emerging areas of emphasis including cyber discrimination, anticipatory stress or vigilance around discrimination, and interventions with potential to reduce the negative effects of discrimination on health. We also discuss priorities for future research and implications for interventions and policy.
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Affiliation(s)
- Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322;
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Rank MA, Shah ND. Multiple chronic conditions and asthma: implications for practice and research. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2014; 2:518-24. [PMID: 25213044 DOI: 10.1016/j.jaip.2014.06.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 06/26/2014] [Accepted: 06/30/2014] [Indexed: 10/24/2022]
Abstract
At least half of US adults with asthma have at least 1 other chronic condition. Having asthma and other chronic conditions are associated with poorer asthma outcomes. Several studies considered the relationship between asthma and other specific chronic conditions; results of these studies indicated that having depression or anxiety and/or panic disorder is associated with an increased risk of developing a new asthma diagnosis and with poorer asthma outcomes. In addition, results of these studies indicated that having asthma is associated with an increased risk of developing a new depression or anxiety and/or panic disorder diagnosis. Theoretical models for understanding multiple chronic conditions have emerged, with models that include a balance between patient workload and capacity; classification of specific conditions as concordant and/or discordant and/or dominant; and identification of the gap between what a patient needs and what health care services are able to offer. Potential implications for clinical providers include screening for chronic conditions not yet recognized, such as mental health disorders, promoting and tracking medication adherence in those who have multiple chronic conditions, and simplifying treatment regimens to reduce patient workload.
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Affiliation(s)
- Matthew A Rank
- Division of Allergy, Asthma, and Clinical Immunology, Mayo Clinic, Scottsdale, Ariz; The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minn.
| | - Nilay D Shah
- The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minn; Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minn
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Carroll KN. Can the blues make it harder to breathe? Am J Respir Crit Care Med 2014; 189:1013-4. [PMID: 24787060 DOI: 10.1164/rccm.201402-0320ed] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kecia N Carroll
- 1 Department of Pediatrics Vanderbilt University Medical Center Nashville, Tennessee
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