1
|
Azzi V, Karam JM, D'Andrea W, Malaeb D, El Khatib S, Sakr F, Dabbous M, Hallit S, Soufia M. Are the presence of asthma and the COVID-19 infection associated with behavioral changes in Lebanese adolescents? Allergol Immunopathol (Madr) 2024; 52:68-79. [PMID: 38459893 DOI: 10.15586/aei.v52i2.1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/13/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Little evidence is available about psychological stressors in Lebanese asthmatic adolescents, where health-risk behaviors are a serious threat to public health. In addition, the COVID-19 epidemic has had a substantial influence on adolescents' mental health globally, especially in Lebanon, where the ongoing economic and political challenges have largely impacted their psychological well-being. This study aimed to explore the association of asthma and the COVID-19 infection with behaviors among Lebanese adolescents. METHODS Data were collected in July 2023, using the snowball sampling technique. Inclusion criteria for participation in the study included being of a resident and citizen of Lebanon and aged 12-18 years. Behavioral problems were assessed using the Youth Self-Report (YSR) scale, which yields nine subscales (anxious/depressed, withdrawn/depressed, somatic complaints, social problems, thought problems, attention problems, rule-breaking behavior, aggressive behavior, and other problems) and a total score. RESULTS Asthma was significantly associated with somatic complaints (Beta [β] = 2.98), attention problems (β = 0.01), and other behavioral problems (β = 0.68). Having contracted the COVID-19 infection, compared to healthy asymptomatic state (β = 1.55), was significantly associated with more anxious behaviors. In the case of stratifying the analysis in terms of gender, the results showed that the presence of asthma was significantly associated with more social behaviors (β = 3.31), thought problems (β = 2.91), attention problems (β = 0.02), other behavioral problems (β = 1.71), and total behavioral problems (β = 5.71) in males. In case stratifying the analysis as to school type, the presence of asthma was significantly associated with more somatic complaints (β = 2.77) in participants from private schools whereas it was significantly associated with more total behavioral problems (total YSR scores) (β = 5.05) in participants from public schools. CONCLUSION It is confirmed that asthma and psychiatric disorders are interconnected, so it would be of great importance to include screening through a psychological intervention in treating asthmatic adolescents by means of (1) recognizing factors affecting patients' mental health, and (2) regulating uncontrolled behaviors that can exacerbate symptoms in order to avoid the future morbidity.
Collapse
Affiliation(s)
- Vanessa Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | | | - Wendy D'Andrea
- The New School for Social Research, New York, NY, USA
- Trauma Research Foundation, Brooklyn, MA, USA
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Sami El Khatib
- Department of Biomedical Sciences, School of Arts and Sciences, Lebanese International University, Bekaa, Lebanon
- Center for Applied Mathematics and Bioinformatics (CAMB), Gulf University for Science and Technology (GUST), Hawally, Kuwait
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil, Paris, France
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan;
| | - Michel Soufia
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| |
Collapse
|
2
|
Gibson-Scipio W, Dinaj V, Hall A, Kormelink A, Bruzzese JM, MacDonell KK. Anxiety, depression and global distress among African American young adults with uncontrolled asthma. J Asthma 2023; 60:1836-1842. [PMID: 36952598 PMCID: PMC10524604 DOI: 10.1080/02770903.2023.2193632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/06/2023] [Accepted: 03/16/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Anxiety and depression are mental health disorders that are often comorbid with asthma. Urban African American young adults with asthma often experience increased risk of anxiety and depression. OBJECTIVE To explore relationships between symptoms of psychological distress and asthma-related anxiety with asthma outcomes among urban African American young adults with poorly controlled persistent asthma. METHODS A secondary analysis of baseline data from a larger study of 141 African American young adults with uncontrolled persistent asthma was examined. Participants completed the Brief Symptom Inventory (BSI-18), Youth Asthma-related Anxiety Scale, Asthma Control Test (ACT), a daily diary to assess asthma symptoms; and number of asthma attacks. Spirometry assessed airway obstruction. Generalized linear models tested associations. RESULTS In multivariable models testing, higher somatization scores were significantly associated with lower ACT scores (adjusted β = -0.49; 95% CI = -0.69, -0.28; p < 0.01), and higher symptoms (adjusted β = 0.39; 95% CI = 0.14, 0.65; p < 0.01). After adding asthma-related anxiety to the model, the somatization subscale and asthma-related anxiety were significantly associated with ACT scores (adjusted β = -0.36; 95% CI = -0.57, -0.15; p < 0.01), (adjusted β = -0.32; 95% CI = -0.50, -0.14; p < 0.01), respectively. Asthma-related anxiety was also significantly associated with asthma attacks (adjusted β = 0.24; 95% CI = 0.05, 0.43; p < 0.05). CONCLUSION This study suggests, asthma-related anxiety may differ from general anxiety and be related to poorly controlled asthma among African American young adults.
Collapse
Affiliation(s)
| | - Veronica Dinaj
- Wayne State University School of Medicine, Detroit, MI, USA
| | - Amy Hall
- Wayne State University College of Nursing, Detroit, MI, USA
| | | | | | - Karen Kolmodin MacDonell
- Wayne State University College of Nursing, Detroit, MI, USA
- Wayne State University School of Medicine, Detroit, MI, USA
- Florida State University College of Medicine, Tallahassee, FL, USA
| |
Collapse
|
3
|
Ashager K, Feleke MG, Degefu S, Elfios E, Getnet A, Ezo E, Sintayehu M. Psychological distress and associated factors among asthmatic patients in Southern, Ethiopia, 2021. Asthma Res Pract 2023; 9:4. [PMID: 37271820 DOI: 10.1186/s40733-023-00093-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 05/22/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND There is an increased prevalence of psychological distress in adults with asthma. Psychological distress describes unpleasant feelings or emotions that impact the level of functioning. It is a significant exacerbating factor in asthma control. Addressing factors that contribute to psychological distress in those asthma patients improves asthma outcomes. So, this study aimed to assess the prevalence of psychological distress and associated factors among asthmatic patients at Hawassa public hospitals, Ethiopia, 2021. METHODS Institution-based cross-sectional study design was used to select 394 asthma patients. Proportional allocation and systematic sampling techniques were used to select study participants. A logistic regression model was used to assess the predictors and psychological distress of the asthmatic patient. The association was interpreted using the odds ratio and 95% confidence interval. RESULT A total of 394 asthma patients participated in the study, giving a response rate of 93.4%. The prevalence of psychological distress among asthmatic patients was 51% [95%CI: 46%-56%]. Participants who had comorbid medical illness [AOR: 6.049, 95% CI (3.131-11.684)], experienced stigma [AOR: 3.587, 95%CI (1.914-6.723)], chewed khat [AOR: 7.268, 95%CI (3.468-15.231)], had poor social support and had uncontrolled asthma were significantly associated with psychological distress in asthmatic patients. CONCLUSION This study demonstrated that the prevalence of psychological distress was found to be high among asthmatic patients. Social support, stigma, chewing khat, comorbid medical illness, and poor asthmatic control had significantly associated with psychological distress in asthmatic patients.
Collapse
Affiliation(s)
- Kidist Ashager
- Department of Nursing, School of Nursing, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, Ethiopia.
| | - Mulualem Gete Feleke
- Department of Nursing, School of Nursing, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, Ethiopia.
| | - Sindu Degefu
- Department of Nursing, School of Nursing, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, Ethiopia
| | - Eshetu Elfios
- Department of Nursing, School of Nursing, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, Ethiopia
| | - Asmamaw Getnet
- Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Elias Ezo
- Department of Nursing, College of Medicine and Health Sciences, Wachamo University, Hosaena, Ethiopia
| | - Mezinew Sintayehu
- Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| |
Collapse
|
4
|
Romanazzo S, Mansueto G, Cosci F. Anxiety in the Medically Ill: A Systematic Review of the Literature. Front Psychiatry 2022; 13:873126. [PMID: 35722552 PMCID: PMC9203680 DOI: 10.3389/fpsyt.2022.873126] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although anxiety is highly represented in the medically ill and its occurrence has relevant clinical implications, it often remains undetected and not properly treated. This systematic review aimed to report on anxiety, either symptom or disorder, in patients who suffer from a medical illness. METHODS English-language papers reporting on anxiety in medically ill adults were evaluated. PubMed, PsycINFO, Web of Science, and Cochrane databases were systematically searched from inception to June 2021. Search term was "anxiety" combined using the Boolean "AND" operator with "medically ill/chronic illness/illness/disorder/disease." Risk of bias was assessed via the Joanna Briggs Institute (JBI) Critical Appraisal Tools-Checklist for Prevalence Studies. The PRISMA guidelines were followed. RESULTS Of 100,848 citations reviewed, 329 studies met inclusion criteria. Moderate or severe anxious symptoms were common among patients with cardiovascular, respiratory, central nervous system, gastrointestinal, genitourinary, endocrine, musculoskeletal system or connective tissue, dermatological diseases, cancer, AIDS and COVID-19 infections. The most common anxiety disorder was generalized anxiety disorder, observed among patients with cardiovascular, respiratory, central nervous system, dermatologic diseases, cancer, primary aldosteronism, amenorrhea, and COVID-19 infection. Panic disorder was described for cardiovascular, respiratory, dermatology diseases. Social anxiety was found for cardiovascular, respiratory, rheumatoid diseases. Specific phobias were relatively common in irritable bowel syndrome, gastroesophageal reflux, end-stage renal disease. CONCLUSION Anxiety is a major challenge in medical settings. Recognition and proper assessment of anxiety in patients who suffer from a medical illness is necessary for an appropriate management. Future reviews are warranted in order also to clarify the causal and temporal relationship between anxiety and organic illness.
Collapse
Affiliation(s)
- Sara Romanazzo
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giovanni Mansueto
- Department of Health Sciences, University of Florence, Florence, Italy.,Clinical Pharmacopsychology Laboratory, University of Florence, Florence, Italy
| | - Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy.,Clinical Pharmacopsychology Laboratory, University of Florence, Florence, Italy.,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| |
Collapse
|
5
|
Aljemaiah AI, Osman M, Alharbi S, Alshehri R, Aldggag EM, Aljoudi AT, Abdulsomad DS, Abdulghani M, Alotaibi F. Fear at the time of the COVID-19 pandemic: validation of the Arabic version of the Four-Dimensional Symptom Questionnaire among Saudi-based respondents. BJPsych Open 2021; 7:e33. [PMID: 33431095 PMCID: PMC7804080 DOI: 10.1192/bjo.2020.166] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/19/2020] [Accepted: 12/17/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has caused unprecedented stress and fear throughout the world. AIMS To evaluate the psychological effects of the COVID-19 pandemic on the Saudi public, and to examine the performance of the Arabic version of the Four-Dimensional Symptom Questionnaire (4DSQ) scale. METHOD We conducted an online questionnaire-based cross-sectional survey of a sample of the Saudi public. RESULTS The study included 347 participants, who reported significantly higher levels of distress, depressive symptoms, anxiety symptoms and somatisation compared with a normative sample. Females scored higher in terms of somatisation, depression and anxiety symptoms, and distress. Obtaining COVID-19 information from friends and relatives was associated with higher levels of somatisation, depression and anxiety symptoms, and distress. Cronbach's alpha was 0.93 for the distress scale, 0.88 for the depression scale, 0.88 for the anxiety scale and 0.86 for the somatisation scale. CONCLUSIONS Levels of psychological distress were high among the Saudi public during the COVID-19 pandemic. We found high reliability for the Arabic version of the 4DSQ scale. However, three items did not conform to the four-factor structure, namely, item 1: 'During the past week, did you suffer from dizziness or feeling light-headed?', item 20: 'During the past week, did you suffer from disturbed sleep?' and item 46: 'During the past week did you ever think I wish I was dead?'.
Collapse
Affiliation(s)
| | - Mugtaba Osman
- Armed Forces Center for Psychiatric Care, Taif, Saudi Arabia
| | - Sarah Alharbi
- Armed Forces Center for Psychiatric Care, Taif, Saudi Arabia
| | - Randa Alshehri
- Armed Forces Center for Psychiatric Care, Taif, Saudi Arabia
| | | | | | | | - Mohammed Abdulghani
- Armed Forces Center for Psychiatric Care, Taif, Saudi Arabia; and Department of Psychiatry, Faculty of Medicine, Zagazig University, Egypt
| | - Fawaz Alotaibi
- Armed Forces Center for Psychiatric Care, Taif, Saudi Arabia
| |
Collapse
|
6
|
Khosravani V, Samimi Ardestani SM, Alvani A, Amirinezhad A. Alexithymia, empathy, negative affect and physical symptoms in patients with asthma. Clin Psychol Psychother 2020; 27:736-748. [PMID: 32285550 DOI: 10.1002/cpp.2458] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/07/2020] [Accepted: 04/07/2020] [Indexed: 02/07/2023]
Abstract
Although alexithymia has been found to be associated with physical symptoms in psychosomatic disorders such as asthma, mechanisms linking this association are unknown. However, affective alexithymic features may be associated with physical symptoms in the presence of deficits in affective characteristics such as low empathy and high negative affect. This study aimed to assess direct effects of alexithymic traits on physical symptoms and indirect effects of these subscales through empathy and negative affect (e.g. depressive, anxious and stress symptoms) by controlling for asthma severity in patients with asthma. Three hundred patients with asthma completed the Toronto Alexithymia Scale-20 (TAS-20), the Basic Empathy Scale (BES), the Depression Anxiety Stress Scales-21 (DASS-21) and the Physical Symptoms Inventory (PSI). After controlling for asthma severity, the results showed that alexithymia subscales of the TAS-20 had no direct effects on physical symptoms, but the difficulty in identifying feelings (DIF) subscale of the TAS-20 was associated with affective empathy and negative affect. Affective empathy was significantly related to negative affect. Affective empathy and negative affect were associated with physical symptoms. The affective subscale of alexithymia on the TAS-20, that is DIF, indirectly affected physical symptoms through affective empathy and negative affect. Findings suggest that patients with asthma who have high levels of DIF may show high physical symptoms in the presence of low affective empathy and high negative affect.
Collapse
Affiliation(s)
- Vahid Khosravani
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mehdi Samimi Ardestani
- Department of Psychiatry, Behavioral Sciences Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amin Alvani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Ali Amirinezhad
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| |
Collapse
|
7
|
Woledesenbet MA, Shumet Mekonen S, Sori LM, Abegaz TM. Epidemiology of Depression and Associated Factors among Asthma Patients in Addis Ababa, Ethiopia. PSYCHIATRY JOURNAL 2018; 2018:5934872. [PMID: 30225243 PMCID: PMC6129350 DOI: 10.1155/2018/5934872] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 07/07/2018] [Accepted: 07/16/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Depression in asthma patients can cause worsening of respiratory symptoms. Addressing mental illness in those with asthma improves asthma outcomes. This study aimed to assess the epidemiology of depression and associated factors among asthma patients attending government hospitals in Ethiopia. METHODS Institutional based cross-sectional study was conducted on patients with asthma at three governmental hospitals of Addis Ababa from June to July 2017. Patient health questionnaire (PHQ-9) depression scale was used to assess prevalence of depression among asthmatic patients. The data were entered and analyzed using SPSS version 20 statistical software. Binary logistic regression analysis was conducted to identify associated factors for depression. To indicate the strength of association, odds ratios (OR) and 95% confidence intervals (95% CI) were used. RESULT A total of 405 participants were enrolled in the study giving an overall response rate of 96%. The respondents had mean age of 54.46 and standard deviation (SD) of 10.01 years. About 273 (67.4%) were females. The prevalence of depression among asthma patients was 85 (21%). The odds of developing depression among single asthma patients were increased by 1.63 with 95% CI [1. 8, 3.493]. Depression among asthma patients who had comorbid cardiac illness was 6.2 times higher than those who do not have at CI [1.145, 24.109]. The prevalence of depression among uncontrolled asthma patients was 8 times higher than those with well-controlled asthma at CI [1.114, 19.025]. CONCLUSION One-fifth of asthmatic patients were experiencing depression. Uncontrolled asthma, comorbid cardiac illness, and single patients were important predictors of depression among asthmatic patients. Proper control of asthmatic attack and cardiac illnesses is very important to reduce the burden of depression.
Collapse
Affiliation(s)
- Mebrat Abera Woledesenbet
- University of Gondar Hospital, College of Medicine and Health Sciences, Department of Psychiatry, Ethiopia
| | - Shegaye Shumet Mekonen
- University of Gondar, College of Medicine and Health Sciences, Department of Psychiatry, Ethiopia
| | - Lamesa Melese Sori
- University of Gondar Hospital, College of Medicine and Health Sciences, Department of Psychiatry, Ethiopia
| | - Tadesse Melaku Abegaz
- University of Gondar, College of Medicine and Health Sciences, Department of Clinical Pharmacy, Ethiopia
| |
Collapse
|