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Storer B, Holden M, Kershaw KA, Braund TA, Chakouch C, Coleshill MJ, Haffar S, Harvey S, Sicouri G, Newby J, Murphy M. The prevalence of anxiety in respiratory and sleep diseases: A systematic review and meta-analysis. Respir Med 2024; 230:107677. [PMID: 38823565 DOI: 10.1016/j.rmed.2024.107677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/07/2024] [Accepted: 05/22/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Anxiety is common in those with chronic physical health conditions and can have significant impacts on both quality of life and physical health outcomes. Despite this, there are limited studies comprehensively investigating the prevalence of anxiety in respiratory and sleep medicine settings. This systematic review and meta-analysis aims to provide insight into the global prevalence of anxiety symptoms/disorders in respiratory and sleep medicine outpatients. METHODS PubMed, Embase, Cochrane, PsycINFO and Google Scholar databases were searched from database inception to January 23, 2023 for studies assessing the prevalence of anxiety in adult (≥16 years) respiratory and sleep medicine outpatients. Data was screened and extracted independently by two investigators. Anxiety was measured using various self-report questionnaires, structured interviews, and/or patient records. Using CMA software for the meta-analysis, a random-effects model was used for pooled estimates, and subgroup analysis was conducted on relevant models using a mixed-effects model. RESULTS 116 studies were included, featuring 36,340 participants across 40 countries. The pooled prevalence of anxiety was 30.3 % (95%CI 27.9-32.9 %, 10,679/36,340). Subgroup analysis found a significant difference across type of condition, with pulmonary tuberculosis the highest at 43.1 % and COVID-19 outpatients the lowest at 23.4 %. No significant difference was found across anxiety types, country or age. Female sex and the use of self-report measures was associated with significantly higher anxiety estimates. CONCLUSIONS Anxiety is a common experience amongst patients in respiratory and sleep medicine outpatient settings. Thus, it is crucial that anxiety identification and management is considered by physicians in the field. REGISTRATION The protocol is registered in PROSPERO (CRD42021282416).
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Affiliation(s)
- Ben Storer
- Clinical Research Department, The Black Dog Institute, Sydney, Australia
| | - Monique Holden
- Clinical Research Department, The Black Dog Institute, Sydney, Australia
| | - Kelly Ann Kershaw
- Clinical Research Department, The Black Dog Institute, Sydney, Australia
| | - Taylor A Braund
- Clinical Research Department, The Black Dog Institute, Sydney, Australia; School of Clinical Medicine, Faculty of Medicine and Health, UNSW, Sydney, Australia
| | - Cassandra Chakouch
- Clinical Research Department, The Black Dog Institute, Sydney, Australia
| | | | - Sam Haffar
- Clinical Research Department, The Black Dog Institute, Sydney, Australia
| | - Samuel Harvey
- Clinical Research Department, The Black Dog Institute, Sydney, Australia; School of Clinical Medicine, Faculty of Medicine and Health, UNSW, Sydney, Australia
| | - Gemma Sicouri
- Clinical Research Department, The Black Dog Institute, Sydney, Australia; School of Psychology, Faculty of Science, UNSW, Sydney, Australia
| | - Jill Newby
- Clinical Research Department, The Black Dog Institute, Sydney, Australia; School of Psychology, Faculty of Science, UNSW, Sydney, Australia
| | - Michael Murphy
- Clinical Research Department, The Black Dog Institute, Sydney, Australia; School of Clinical Medicine, Faculty of Medicine and Health, UNSW, Sydney, Australia.
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Feng Z, Wang J, Xie Y, Li J. Effects of exercise-based pulmonary rehabilitation on adults with asthma: a systematic review and meta-analysis. Respir Res 2021; 22:33. [PMID: 33516207 PMCID: PMC7847170 DOI: 10.1186/s12931-021-01627-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 01/18/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Pulmonary rehabilitation (PR) has been proposed as an effective method for many respiratory diseases. However, the effects of exercise-based PR on asthma are currently inconclusive. This review aimed to investigate the effects of exercise-based PR on adults with asthma. METHODS The PubMed, Embase, Cochrane Library, Web of Science, International Clinical Trials Registry Platform and ClinicalTrials.gov databases were searched from inception to 31 July 2019 without language restriction. Randomized controlled trials (RCTs) investigating the effects of exercise-based PR on adults with asthma were included. Study selection, data extraction and risk of bias assessment were performed by two investigators independently. Meta-analysis was conducted by RevMan software (version 5.3). Evidence quality was rated by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. RESULTS Ten literatures from nine studies (n = 418 patients) were identified. Asthma quality of life questionnaire total scores (MD = 0.39, 95% CI: 0.02 to 0.76) improved significantly in the experimental group compared to control group, including activity domain scores (MD = 0.58, 95% CI: 0.21 to 0.94), symptom domain scores (MD = 0.52, 95% CI: 0.19 to 0.85), emotion domain scores (MD = 0.53, 95% CI: - 0.03 to 1.09) and environment domain scores (MD = 0.56, 95% CI: 0.00 to 1.11). Both the 6-min walk distance (MD = 34.09, 95% CI: 2.51 to 65.66) and maximum oxygen uptake (MD = 4.45, 95% CI: 3.32 to 5.58) significantly improved. However, improvements in asthma control questionnaire scores (MD = - 0.25, 95% CI: - 0.51 to 0.02) and asthma symptom-free days (MD = 3.35, 95% CI: - 0.21 to 6.90) were not significant. Moreover, there was no significant improvement (MD = 0.10, 95% CI: - 0.08 to 0.29) in forced expiratory volume in 1 s. Nonetheless, improvements in forced vital capacity (MD = 0.23, 95% CI: 0.08 to 0.38) and peak expiratory flow (MD = 0.39, 95% CI: 0.21 to 0.57) were significant. CONCLUSIONS Exercise-based PR may improve quality of life, exercise tolerance and some aspects of pulmonary function in adults with asthma and can be considered a supplementary therapy. RCTs of high quality and large sample sizes are required. CLINICAL TRIAL REGISTRATION The review was registered with PROSPERO (The website is https://www.crd.york.ac.uk/prospero/ , and the ID is CRD42019147107).
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Affiliation(s)
- Zhenzhen Feng
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.,Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases By Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, 156 Jinshui East Road, Zhengzhou, 450046, China.,Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, 450046, China
| | - Jiajia Wang
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases By Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, 156 Jinshui East Road, Zhengzhou, 450046, China.,Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, 450046, China.,Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 450000, China
| | - Yang Xie
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases By Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, 156 Jinshui East Road, Zhengzhou, 450046, China.,Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, 450046, China.,Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 450000, China
| | - Jiansheng Li
- Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases By Henan & Education Ministry of P.R. China, Henan University of Chinese Medicine, 156 Jinshui East Road, Zhengzhou, 450046, China. .,Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, 450046, China. .,Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 450000, China.
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Dafauce L, Romero D, Carpio C, Barga P, Quirce S, Villasante C, Bravo MF, Álvarez-Sala R. Psycho-demographic profile in severe asthma and effect of emotional mood disorders and hyperventilation syndrome on quality of life. BMC Psychol 2021; 9:3. [PMID: 33407846 PMCID: PMC7788781 DOI: 10.1186/s40359-020-00498-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 12/02/2020] [Indexed: 01/10/2023] Open
Abstract
Background Severe asthma affects a small population but carries a high psychopathological risk. Therefore, the psychodemographic profile of these patients is of interest. A substantial prevalence of anxiety, depression, alexithymia and hyperventilation syndrome in severe asthma is known, but contradictory results have been observed. These factors can also affect patients’ quality of life. For this reasons, our purpose is to evaluate the psychodemographic profile of patients with severe asthma and assess the prevalence of anxiety, depression, alexithymia and hyperventilation syndrome and their impact on the quality of life of patients with severe asthma. Methods A cross-sectional study of 63 patients with severe asthma. Their psychodemographic profile was evaluated using the Hospital Anxiety and Depression Scale (HADS), Toronto Alexithymia Scale (TAS-20), Nijmegen questionnaire and Asthma Control Test (ACT) to determine the state of anxiety and depression, alexithymia, hyperventilation syndrome and control of asthma, respectively. Quality of life was assessed with the Mini Asthma Quality of Life Questionnaire (Mini-AQLQ). Results The mean age was 60 ± 13.6 years. Personal psychopathological histories were found in 65.1% of participants, and 8% reported previous suicidal attempts. The rate of anxiety and/or depression (HADS ≥ 11) was 68.3%. These patients present higher scores on the TAS-20 (p < 0.001) for the level of dyspnea (p = 0.021), and for emotional function (p = 0.017) on the Mini-AQLQ, compared with patients without anxiety or depression. Alexithymia (TAS-20 ≥ 61) was observed in 42.9% of patients; these patients were older (p = 0.037) and had a higher HADS score (p = 0.019) than patients with asthma without alexithymia. On the other hand, patients with hyperventilation syndrome (Nijmegen ≥ 23) scored higher on the HADS (p < 0.05), on the Mini-AQLQ (p = 0.002) and on the TAS-20 (p = 0.044) than the group without hyperventilation syndrome. Quality of life was related to anxiety-depression symptomatology (r = − 0.302; p = 0.016) and alexithymia (r = − 0.264; p = 0.036). Finally, the Mini-AQLQ total score was associated with the Nijmegen questionnaire total score (r = − 0.317; p = 0.011), and the activity limitation domain of the Mini-AQLQ correlated with the ACT total score (r = 0.288; p = 0.022). Conclusions The rate of anxiety, depression, alexithymia and hyperventilation syndrome is high in patients with severe asthma. Each of these factors is associated with a poor quality of life.
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Affiliation(s)
- Lucía Dafauce
- Psychiatry and Psychology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain.
| | - David Romero
- Pneumology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain
| | - Carlos Carpio
- Pneumology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain
| | - Paula Barga
- Psychiatry and Psychology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain
| | - Santiago Quirce
- Allergology Services, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain
| | - Carlos Villasante
- Pneumology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain
| | - María Fe Bravo
- Psychiatry and Psychology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain
| | - Rodolfo Álvarez-Sala
- Pneumology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, CIBERES, Madrid, Spain
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Bedolla-Barajas M, Morales-Romero J, Fonseca-López JC, Pulido-Guillén NA, Larenas-Linnemann D, Hernández-Colín DD. Anxiety and depression in adult patients with asthma: the role of asthma control, obesity and allergic sensitization. J Asthma 2020; 58:1058-1066. [PMID: 32312136 DOI: 10.1080/02770903.2020.1759087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine the frequency of anxiety and depression in adult patients with asthma and to identify factors associated with them. METHODS This cross-sectional study included 164 consecutively recruited patients with asthma aged ≥ 18 years. Participants were clinically assessed and the mental state was analyzed through of the Beck Anxiety Inventory (BAI), the Beck Depression Inventory II (BDI-II); the Asthma Control Test (ACT) was measured, and allergic sensitization and respiratory function were also evaluated. Binary logistic regression models to identify the factors related to anxiety or depression were carried out. Complementary, 95% confidence intervals (CI) were estimated. RESULTS Anxiety was present in 54.3% of patients (95% CI: 46.6%-61.7%) while depression was found in 50.6% (95% CI: 43.0%-58.2%). Depression increased the odds of anxiety in patients with asthma (OR: 26.00, p < 0.0001), whereas an ACT score ≥ 20 points and allergic asthma were associated with a lower odds than the reference group (OR: 0.29; p = 0.007 and OR: 0.29; p = 0.024, respectively). Depression was associated with anxiety and obesity (OR: 25.33, p < 0.0001 and OR: 3.66; p = 0.014, respectively). CONCLUSIONS Overall, more than half of all asthmatic patients suffer from anxiety and depression. Well-controlled asthma and allergic sensitization decreased the likelihood of anxiety, while depression was associated with both obesity and anxiety.
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Affiliation(s)
- Martín Bedolla-Barajas
- Servicio de Alergia e Inmunología Clínica, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Jalisco, México
| | | | - Juan Carlos Fonseca-López
- Servicio de Urgencias Adultos, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Jalisco, México
| | - Norma Angélica Pulido-Guillén
- Centro Universitario de Ciencias de la Salud, Maestría en Ciencias de la Salud de la Adolescencia y la Juventud, Universidad de Guadalajara, Guadalajara, Mexico
| | | | - Dante Daniel Hernández-Colín
- Servicio de Alergia e Inmunología Clínica, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Jalisco, México
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Wang N, Huang B, Ruan Y, Amico KR, Vermund SH, Zheng S, Qian HZ. Association between stigma towards HIV and MSM and intimate partner violence among newly HIV-diagnosed Chinese men who have sex with men. BMC Public Health 2020; 20:204. [PMID: 32039716 PMCID: PMC7008577 DOI: 10.1186/s12889-020-8259-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 01/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HIV- and MSM-related stigma are well documented as common for Chinese men who have sex with men (MSM) living with HIV, yet there is sparse literature on intimate partner violence (IPV) and its relationship with stigma in this vulnerable population. To evaluate the association between HIV-stigma and stigma related to homosexuality and IPV among newly HIV-diagnosed MSM in China. METHODS Data were collected in the baseline survey among newly HIV-diagnosed Chinese MSM in a randomized clinical trial via face-to-face interviews. Univariate logistic and multivariate logistic regression analyses were performed to assess the associations between IPV and HIV- and MSM-related stigma. RESULTS Of 367 newly HIV-diagnosed Chinese MSM, 23.7% experienced any IPV, including 16.6% physical, 7.4% psychological and 5.2% sexual IPV. Positive associations were found between HIV- and MSM-related stigma and IPV. Men with high HIV-related stigma (score ≥ 27) were 1.67 times as likely to experience any IPV as those with low stigma (adjusted odds ratio [AOR]: 1.67, 95% confidence interval [CI]: 1.02-2.76). Men with high MSM-related stigma (score ≥ 6) were 1.99 times as likely to experience any IPV as those with low stigma (AOR: 1.99, 95% CI: 1.18-3.36). CONCLUSIONS HIV- and MSM-related stigmas was positively associated with IPV experiences among newly diagnosed MSM in China. The manner in which stigma may exacerbate IPV, and/or the influence of IPV on worsening stigma should be further evaluated. The high prevalence of IPV and stigma in this population suggests that interventions should be taken to reduce stigma and prevent this risky behavior among MSM.
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Affiliation(s)
- Na Wang
- School of Public Health, Guilin Medical University, Guilin, China
- Guangxi Key Laboratory of AIDS Prevention and Treatment, Nanning, China
| | - Bo Huang
- School of Public Health, Guilin Medical University, Guilin, China
| | - Yuhua Ruan
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - K. Rivet Amico
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI USA
| | | | - Shimin Zheng
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN USA
| | - Han-Zhu Qian
- Yale University School of Public Health, New Haven, CT USA
- SJTU-Yale Joint Center for Biostatistics and Data Science, Shanghai Jiao Tong University (SJTU), Shanghai, China
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Suicidality among patients with asthma: A systematic review and meta-analysis. J Affect Disord 2019; 256:594-603. [PMID: 31299440 DOI: 10.1016/j.jad.2019.06.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/06/2019] [Accepted: 06/29/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Asthma is associated with multiple psychiatric comorbidities. However, the relationship between asthma and suicidality has not be well established. METHODS According to the PRISMA guidelines, protocol of the study was registered in the PROSPERO database (CRD42019123150). A systematic search of the PubMed, Embase and PsycINFO databases was performed for relevant studies published from its inception to January 25, 2019. Studies that reported the risk of suicidal ideation, attempts and mortality in asthmatics compared with non-asthmatics were included. A random-effects model was used to synthesize the estimates and the quality of the included studies was assessed under the Newcastle-Ottawa Scale. RESULTS Twenty-eight studies including 2,759,841 asthmatic patients and 16,290,362 non-asthmatic controls were pooled and analyzed in the current study. The pooled data showed that asthmatic patients had increased risk of exhibiting suicidal ideation (OR, 1.52; 95%CI, 1.37-1.70), suicide attempts (OR, 1.60; 95%CI, 1.33-1.92) and suicide mortality (OR, 1.31; 95%CI, 1.11-1.55) compared to non-asthmatic controls. Noticeably, adolescent asthmatic patients had a more than 2-fold risk of suicide mortality compared to non-asthmatic controls (OR, 2.14; 95%CI, 1.61-2.83). LIMITATIONS The limitations of the present study were variability in study designs and various measures of asthma and suicidality, which possibly contribute to notable heterogeneity. CONCLUSIONS Patients with asthma have a significantly increased risk of suicidal ideation, suicide attempts and suicide mortality. Clinical physicians should pay more attention to the increased risk of suicidality in asthmatics, screen for these suicidal thoughts and behaviors, and make appropriate mental health referrals when necessary.
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Bronchial asthma control degree and the temperament structure according to the Eysenck model. Postepy Dermatol Alergol 2019; 37:559-565. [PMID: 32994779 PMCID: PMC7507172 DOI: 10.5114/ada.2019.83216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 01/31/2019] [Indexed: 02/07/2023] Open
Abstract
Introduction Asthma is a disease of a psychosomatic nature. The control of asthma is still poor in approximately 5% of patients, despite introduction of modern inhalant drugs and psychotherapeutic interventions. Aim To evaluate whether the degree of bronchial asthma control is related to the characteristics of temperament according to Eysenck’s concept. Material and methods The study was conducted on a group of 111 bronchial asthma patients and 44 healthy subjects. In all of them, the Eysenck temperament questionnaire was administered and the level of asthma control was determined. Results Increase in the scale of neuroticism was associated with an 1.83-fold increase in the likelihood of poor asthma control. Increase in the result on the psychoticism scale and lie scale of about one point was associated with a slightly smaller increased risk of poor asthma control (respectively: 1.49-fold and 1.61-fold). Conclusions The structure of temperament of a person with poor control of bronchial asthma can be characterized. Patients with poor asthma control have a higher level of neuroticism, psychoticism and propensity to lie, compared with the healthy population and subjects with good or partial bronchial asthma control.
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