The association of anxiety with asthma among a sample of asthmatics in Ile-Ife Osun State Nigeria

The asthma-anxiety connection

BACKGROUND

The literature reports a significant association between various mental disorders and asthma, in particular depression and/or anxiety, with some more robust data regarding anxiety disorders. However, the nature of this association remains largely unclear.

OBJECTIVES

(1) To test the hypothesis of a specific association of anxiety and depressive disorder (according to the DSM-IV) with asthma and (2) to test the bidirectional hypothesis of causality between asthma and psychiatric disorders.

METHODS

Ninety-six adults were compared with 96 control subjects matched according to main socio-demographic variables (i.e., gender, age, marital status, cohabiting/non-cohabiting, and BMI). Subjects with asthma were divided according to GINA and ACT classifications. All subjects underwent Structured Clinical Interviews for DSM-IV Axis I (SCID-I) diagnosis.

RESULTS

Significant association between asthma and lifetime anxiety disorders emerged (OR 3.03; p = 0.003); no significant association with other psychiatric diagnosis emerged. Moreover, lifetime and current anxiety were associated with asthma severity levels (p < 0.01 and p = 0.001 based on age). Asthma preceded anxiety in 48% of cases; in 52% of cases, anxiety preceded asthma, without significant group differences. The risk of asthma, particularly of severe, uncontrolled forms (p < 0.01), resulted higher in lifetime anxiety disorder patients (p = 0.003 and p = 0.001 based on age at onset). Current anxiety increased the risk of asthma, and that of an uncontrolled form (p < 0.05). Asthma increased the risk of lifetime anxiety disorders (p = 0.002 and p = 0.018 using ages). Intermittent asthma increased the risk of lifetime and current anxiety disorders (p < 0.01).

CONCLUSIONS

Anxiety disorders, in particular Lifetime Anxiety Disorders, represent the only psychiatric disorder significantly associated with asthma, with a possible bidirectional, anxiety-asthma relationship, each of which can be caused or result from the other.

Specific psychiatric morbidity among a sample of asthmatics in south western Nigeria

OBJECTIVE

This study was to identify specific psychiatric morbidity among asthma patients and to compare their rates to controls.

METHOD

Hundred consecutive asthmatics were screened using the General Health Questionnaire (GHQ-30), and the Present State Examination (PSE). The same instruments were also administered to 75 healthy individuals, and 75 orthopaedic patients.

RESULTS

Patients with asthma had a higher occurrence of psychopathology. The specific psychiatric diagnoses among asthmatics were generalized anxiety disorder (23%), depressive disorder (11%), while 2% had panic disorder.

CONCLUSION

Psychiatric morbidity is more common among asthmatics, than the general population and other patient group.

Implications of psychosocial factors as precipitant of asthma attack among a sample of asthmatics

OBJECTIVE

To explore the relationship between psychosocial factors and asthma.

METHODS

One hundred consecutive asthmatics were screened using the 30-item version of the General Health Questionnaire (GHQ-30), Present state examination (PSE) and a socio-demographic schedule incorporating psychosocial variables. Chi-squared test, student "t" test and discriminant analysis were used in analysis.

RESULTS

Among the asthmatics studied 36% had psychopathology. Psychosocial variables significantly associated with psychopathology include worrying, crying, fighting, anger, marital tension, and menstruation. The presence of multiple psychosocial variables was significantly associated with psychopathology.

CONCLUSION

Psychosocial variables predict the presence of psychopathology.