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Zhu M, Chen A. Epidemiological characteristics of asthma-COPD overlap, its association with all-cause mortality, and the mediating role of depressive symptoms: evidence from NHANES 2005-2018. BMC Public Health 2024; 24:1423. [PMID: 38807148 PMCID: PMC11134654 DOI: 10.1186/s12889-024-18911-1] [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: 01/11/2024] [Accepted: 05/21/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Asthma-COPD overlap (ACO) is a distinct and intricate respiratory condition that requires specific attention and management. The objective of this cohort study was to examine the epidemiological characteristics of ACO, explore the association between ACO and all-cause mortality, and investigate the potential mediating role of depressive symptoms in this association. METHODS This retrospective cohort study used data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 and National Death Index (NDI) 2019. A total of 22,745 participants were included: 705 with ACO, 2352 with asthma-only, 853 with COPD-only, and 18,835 without asthma or COPD. The non-ACO group (N = 22,040) referred to the individuals without ACO. Statistical tests were employed to assess differences in some characteristics between the ACO group and the other groups. Cox proportional hazards models were applied to evaluate the relationship between ACO and all-cause mortality, estimating hazard ratios (HR) with 95% confidence intervals. Mediation analysis was conducted to investigate the potential mediating effects of depressive symptoms on the association of ACO with all-cause mortality. RESULTS The prevalence of ACO was 3.10% in our study population. Compared to the non-ACO participants, the ACO participants exhibited significantly different characteristics, including higher age, a lower family income-to-poverty ratio, a higher body mass index, higher rates of comorbidities i.e., hypertension, diabetes, hyperlipidemia, cardiovascular disease, and cancer, poorer dietary habits, and a higher rate of depressive disorders. Compared to the participants without ACO, the participants with ACO exhibited a significant increase in all-cause mortality (HR = 1.908, 95%CI 1.578-1.307, p < 0.001). The proportions mediated by depressive symptoms for ACO -associated all-cause mortality were 8.13% (CI: 4.22%-14.00%, p < 0.001). CONCLUSIONS This study revealed a strong relationship between ACO and all-cause mortality and uncovered a potential psychological mechanism underlying this relationship. Our study indicates the possible necessity of offering comprehensive care to ACO patients, encompassing early detection, lifestyle guidance, and mental health support. Nevertheless, due to the limitations in the study design and the dataset, the results should be interpreted with caution.
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Affiliation(s)
- Meng Zhu
- School of Public Health, Zhejiang Chinese Medical University, No. 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang Province, 310053, China
- School of Basic Medicine, Zhejiang Chinese Medical University, No. 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang Province, 310053, China
| | - An Chen
- School of Public Health, Zhejiang Chinese Medical University, No. 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang Province, 310053, China.
- Department of Public Health, Faculty of Medicine, University of Helsinki, Biomedicum 1, Helsinki, 00290, Finland.
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Abuaish S, Eltayeb H, Bepari A, Hussain SA, Alqahtani RS, Alshahrani WS, Alqahtani AH, Almegbil NS, Alzahrani WN. The Association of Asthma with Anxiety, Depression, and Mild Cognitive Impairment among Middle-Aged and Elderly Individuals in Saudi Arabia. Behav Sci (Basel) 2023; 13:842. [PMID: 37887495 PMCID: PMC10604786 DOI: 10.3390/bs13100842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/27/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
Asthma is a common chronic inflammatory condition with increasing global prevalence. There is some evidence highlighting the effect of asthma on brain functioning. In Saudi Arabia, limited studies have examined the relationship between asthma and mental health, including cognition and mood disorders in older adults in particular. In this study, we examine the association between asthma and mental health outcomes in middle-aged and elderly individuals in Riyadh, Saudi Arabia. In a cross-sectional study, 243 subjects were recruited from outpatient clinics between 2020-2021 (non-asthmatic: n = 159, asthmatic: n = 84). The Montreal Cognitive Assessment test, the Hospital Anxiety and Depression Scale, and the Asthma Control Test were used to assess cognition, anxiety and depression, and asthma control, respectively. Logistic regression analysis while controlling for covariates revealed an association between asthma and symptoms of anxiety and depression (OR = 2.40 [95% CI: 1.07-5.35]) and mild cognitive impairment (MCI) (OR = 1.80 [95% CI: 1.00-3.24]). Poorly controlled asthma increased the odds of anxiety cases (OR = 4.88 [95% CI: 1.09-17.2]). Stratifying analysis by age intervals revealed that asthma was associated with symptoms of anxiety and depression (OR = 2.5 [95% CI: 1.00-6.08]) in middle-aged patients only, while elderly asthmatics had increased odds of having MCI (OR = 7.4 [95% CI: 2.34-23.31]). These findings highlight the possible effects of asthma and its control on mental health among middle-aged and elderly individuals in Saudi Arabia.
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Affiliation(s)
- Sameera Abuaish
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (H.E.); (A.B.); (R.S.A.); (W.S.A.); (A.H.A.); (N.S.A.); (W.N.A.)
| | - Huda Eltayeb
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (H.E.); (A.B.); (R.S.A.); (W.S.A.); (A.H.A.); (N.S.A.); (W.N.A.)
| | - Asmatanzeem Bepari
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (H.E.); (A.B.); (R.S.A.); (W.S.A.); (A.H.A.); (N.S.A.); (W.N.A.)
| | - Syed Arif Hussain
- Respiratory Care Department, College of Applied Sciences, Almaarefa University, Riyadh 13713, Saudi Arabia;
| | - Raneem Saad Alqahtani
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (H.E.); (A.B.); (R.S.A.); (W.S.A.); (A.H.A.); (N.S.A.); (W.N.A.)
| | - Waad Saeed Alshahrani
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (H.E.); (A.B.); (R.S.A.); (W.S.A.); (A.H.A.); (N.S.A.); (W.N.A.)
| | - Amjad Hayf Alqahtani
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (H.E.); (A.B.); (R.S.A.); (W.S.A.); (A.H.A.); (N.S.A.); (W.N.A.)
| | - Nada Saad Almegbil
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (H.E.); (A.B.); (R.S.A.); (W.S.A.); (A.H.A.); (N.S.A.); (W.N.A.)
| | - Wafa Nedal Alzahrani
- Department of Basic Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (H.E.); (A.B.); (R.S.A.); (W.S.A.); (A.H.A.); (N.S.A.); (W.N.A.)
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3
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Wang Y, Mou YK, Wang HR, Song XY, Wei SZ, Ren C, Song XC. Brain response in asthma: the role of "lung-brain" axis mediated by neuroimmune crosstalk. Front Immunol 2023; 14:1240248. [PMID: 37691955 PMCID: PMC10484342 DOI: 10.3389/fimmu.2023.1240248] [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: 06/14/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
In addition to typical respiratory symptoms, patients with asthma are frequently accompanied by cognitive decline, mood disorders (anxiety and depression), sleep disorders, olfactory disorders, and other brain response manifestations, all of which worsen asthma symptoms, form a vicious cycle, and exacerbate the burden on families and society. Therefore, studying the mechanism of neurological symptoms in patients with asthma is necessary to identify the appropriate preventative and therapeutic measures. In order to provide a comprehensive reference for related research, we compiled the pertinent literature, systematically summarized the latest research progress of asthma and its brain response, and attempted to reveal the possible "lung-brain" crosstalk mechanism and treatment methods at the onset of asthma, which will promote more related research to provide asthmatic patients with neurological symptoms new hope.
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Affiliation(s)
- Yao Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China
- Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China
| | - Ya-Kui Mou
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China
- Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China
| | - Han-Rui Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China
- Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China
| | - Xiao-Yu Song
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China
- Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China
| | - Shi-Zhuang Wei
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China
- Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China
| | - Chao Ren
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China
- Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China
- Shandong Provincial Innovation and Practice Base for Postdoctors, Yantai Yuhuangding Hospital, Yantai, China
- Department of Neurology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Xi-Cheng Song
- Department of Otorhinolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China
- Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai Yuhuangding Hospital, Yantai, China
- Shandong Provincial Innovation and Practice Base for Postdoctors, Yantai Yuhuangding Hospital, Yantai, China
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Valdevilla Figueira JA, Mautong H, Camacho L G, Cherrez M, Orellana Román C, Alvarado-Villa GE, Sarfraz Z, Sarfraz A, Agolli A, Farfán Bajaña MJ, Vanegas E, Felix M, Michel J, Espinoza-Fuentes F, Maquilón JR, Cherrez Ojeda I. Attitudes toward depression among Ecuadorian physicians using the Spanish-validated version of the Revised Depression Attitude Questionnaire (R-DAQ). BMC Psychol 2023; 11:46. [PMID: 36793136 PMCID: PMC9930300 DOI: 10.1186/s40359-023-01072-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
PURPOSE Depression is inadequately recognized and managed, and physicians' attitudes toward this condition and its treatment may play a part in this. This study aimed to assess Ecuadorian physicians' attitudes toward depression. METHODS This was a cross-sectional study conducted using the validated Revised Depression Attitude Questionnaire (R-DAQ). The questionnaire was delivered to Ecuadorian physicians, and the response rate was 88.8%. RESULTS 76.4% of participants had never received previous training in depression, and 52.1% of them indicated neutral or limited professional confidence when dealing with depressed patients. More than two-thirds of the participants reported an optimistic attitude toward the generalist perspective of depression. CONCLUSION Overall, physicians in Ecuador's healthcare settings were optimistic and held positive attitudes toward patients with depression. However, a lack of confidence in the management of depression and a need for ongoing training were found, especially among medical professionals who are not in daily contact with patients with depression.
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Affiliation(s)
- José Alejandro Valdevilla Figueira
- Instituto de Neurociencias, Guayaquil, Ecuador ,Departamento de Psicología. Facultad de Marketing, Universidad Ecotec, Guayaquil, Ecuador
| | - Hans Mautong
- Respiralab Research Group, Guayaquil, Ecuador ,grid.442156.00000 0000 9557 7590Universidad Espíritu Santo, Km. 2.5 vía La Puntilla, 0901-952 Samborondón, Ecuador
| | - Genesis Camacho L
- grid.411267.70000 0001 2168 1114Universidad del Zulia, Maracaibo, Venezuela
| | | | | | | | - Zouina Sarfraz
- grid.414774.50000 0000 9694 4612Research and Publications, Fatima Jinnah Medical University, Lahore, Pakistan
| | - Azza Sarfraz
- grid.7147.50000 0001 0633 6224Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Arjola Agolli
- Division of Clinical and Translational Research, Larkin Healthcare System, Miami, USA
| | - María José Farfán Bajaña
- Respiralab Research Group, Guayaquil, Ecuador ,grid.442156.00000 0000 9557 7590Universidad Espíritu Santo, Km. 2.5 vía La Puntilla, 0901-952 Samborondón, Ecuador
| | - Emanuel Vanegas
- Respiralab Research Group, Guayaquil, Ecuador ,grid.442156.00000 0000 9557 7590Universidad Espíritu Santo, Km. 2.5 vía La Puntilla, 0901-952 Samborondón, Ecuador ,grid.422616.50000 0004 0443 7226New York City Health + Hospitals, Woodhull, Brooklyn, NY USA
| | - Miguel Felix
- Respiralab Research Group, Guayaquil, Ecuador ,grid.442156.00000 0000 9557 7590Universidad Espíritu Santo, Km. 2.5 vía La Puntilla, 0901-952 Samborondón, Ecuador ,grid.422616.50000 0004 0443 7226New York City Health + Hospitals, Lincoln, Bronx, NY USA
| | - Jack Michel
- Division of Clinical and Translational Research, Larkin Healthcare System, Miami, USA
| | - Fernando Espinoza-Fuentes
- grid.442156.00000 0000 9557 7590Universidad Espíritu Santo, Km. 2.5 vía La Puntilla, 0901-952 Samborondón, Ecuador
| | | | - Ivan Cherrez Ojeda
- Respiralab Research Group, Guayaquil, Ecuador. .,Universidad Espíritu Santo, Km. 2.5 vía La Puntilla, 0901-952, Samborondón, Ecuador.
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5
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Ma R, Romano E, Vancampfort D, Firth J, Stubbs B, Koyanagi A. Association between physical activity and comorbid anxiety/depression in 46 low- and middle-income countries. J Affect Disord 2023; 320:544-551. [PMID: 36209777 PMCID: PMC10166713 DOI: 10.1016/j.jad.2022.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 09/27/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Evidence on the association of low physical activity (PA) with depression or anxiety is well established. Yet, evidence on the association between PA and comorbid anxiety/depression remains scarce, especially in low- and middle-income countries (LMICs). Thus, this study explored this relationship among adults aged ≥18 years from 46 LMICs. METHODS Cross-sectional, community-based data were analyzed from the World Health Survey (WHS). Multivariable multinomial logistic regression analysis was conducted to examine the association between low PA and comorbid anxiety/depression with no anxiety or depression as the base category. RESULTS 237,023 participants [mean (SD) age = 38.4 (16.0) years; 50.8 % female] were included in the analysis. Low PA was significantly associated with depression alone (OR = 1.33; 95%CI = 1.12-1.57) and anxiety alone (OR = 1.37; 95%CI = 1.23-1.53), while the OR was highest among those with comorbid anxiety/depression (OR = 1.75; 95%CI = 1.52-2.01). CONCLUSION Low PA is associated with particularly increased odds for comorbid anxiety/depression. Increasing PA may have a beneficial effect on the prevention of comorbid anxiety/depression. However, future longitudinal research establishing the direction of this relationship is warranted.
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Affiliation(s)
- Ruimin Ma
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AB, UK.
| | - Eugenia Romano
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AB, UK
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven 3000, Belgium; University Psychiatric Centre KU Leuven, Kortenberg 3000, Belgium
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester M13 9PL, UK; NICM Health Research Institute, Western Sydney University, Westmead 2751, Australia
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AB, UK; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, CIBERSAM, ISCIII, 08830 Barcelona, Spain; Institució Catalana de Recerca i Estudis Avancats (ICREA), Pg. Lluis Companys 23, 08010 Barcelona, Spain
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Pezeshki PS, Nowroozi A, Razi S, Rezaei N. Asthma and Allergy. Clin Immunol 2023. [DOI: 10.1016/b978-0-12-818006-8.00002-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Muacevic A, Adler JR, Okoli ML, Ahaiwe O, Ogbu SC, Kim ES, Kirby RS. Association of Depression, Poor Mental Health Status and Asthma Control Patterns in US Adults Using a Data-Reductive Latent Class Method. Cureus 2023; 15:e33966. [PMID: 36820113 PMCID: PMC9938719 DOI: 10.7759/cureus.33966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 01/20/2023] Open
Abstract
Objectives To explore the association between depression, poor mental health status, and asthma control patterns among US adults using a latent class analysis (LCA) approach. Methods We used data from 10,337 adults aged 18 years and above from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey. Data-reductive LCA was used to derive asthma control patterns in the population using class variables indicative of asthma control. Besides univariate analysis, adjusted and unadjusted logistic regression models were used to examine the association of depression and poor mental health on the derived asthma control patterns. Results About 27.8% of adults aged <55 reported depression, while 27.3% aged ≥55 years were depressed. The latent class prevalence of asthma control patterns was 42.8%, 31.1%, and 26.1%, corresponding to good, fair, and poor asthma control patterns, respectively. In adults aged <55 years, odds of depression (OR=1.52, 95% CI=1.27-1.82) and poor mental health (OR=1.58, 95% CI=1.27-1.96) were higher in the poor asthma control group compared to the good asthma control group. Odds for depression (OR=1.28, 95% CI=1.06-1.53) were also higher in the moderate asthma control group compared to the good asthma control group. Among those aged ≥55 years, depression odds (OR=1.57, 95% CI=1.31-1.87) were higher in only the poor asthma control group. Conclusions These findings may have public health implications. Detecting, screening, and treating depression and mental health disorders may help improve asthma control in people with asthma.
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Felez-Nobrega M, Haro JM, Koyanagi A. Multimorbidity, depression with anxiety symptoms, and decrements in health in 47 low- and middle-income countries. J Affect Disord 2022; 317:176-184. [PMID: 36055525 DOI: 10.1016/j.jad.2022.08.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/26/2022] [Accepted: 08/26/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Comorbid depression and anxiety is associated with worse health outcomes compared to depression or anxiety occurring in isolation, but there is little data on its association with multimorbidity. Thus, we investigated this association across 47 low- and middle-income countries, and further explored whether having anxiety symptoms in addition to depression is associated with significant declines in health outcomes among those with multimorbidity. METHODS Cross-sectional, predominantly nationally representative, community-based data were analyzed from the World Health Survey. DSM-IV depression was assessed with the Composite International Diagnostic Interview. Anxiety symptoms referred to severe/extreme problems with worry or anxiety. Ten chronic conditions and health status across five domains (cognition, interpersonal activities, sleep/energy, self-care, pain/discomfort) were assessed. Multivariable regression analyses conducted. RESULTS Data included 237,952 adults aged ≥18 years [mean age (SD) 38.4 (16.0); 50.8 % females]. Compared to no chronic conditions, 2 (OR = 6.86; 95%CI = 5.59-8.42), 3 (OR = 12.33; 95%CI = 9.72-15.63), and ≥4 (OR = 26.55; 95%CI = 20.21-35.17) chronic conditions were associated with significantly higher odds for comorbid depression/anxiety symptoms (vs. no depression or anxiety symptoms) in the multinomial logistic regression model. Among those with depression and multimorbidity, anxiety symptoms were associated with significantly worse health status across all domains. LIMITATIONS Cross-sectional design, depression and anxiety symptoms were not based on a clinical assessment. CONCLUSIONS Comorbid depression/anxiety is common in people with multimorbidity, and anxiety symptoms in people with depression and multimorbidity signify worse health status. Future studies should assess the utility of screening for and treating comorbid depression/anxiety in patients with multimorbidity in terms of clinical outcomes.
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Affiliation(s)
- M Felez-Nobrega
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centre for Biomedical Research on Mental Health (CIBERSAM), Spain.
| | - J M Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centre for Biomedical Research on Mental Health (CIBERSAM), Spain
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centre for Biomedical Research on Mental Health (CIBERSAM), Spain; ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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9
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Smith L, Shin JI, Song TJ, Underwood BR, Jacob L, López Sánchez GF, Schuch F, Oh H, Veronese N, Soysal P, Butler L, Barnett Y, Koyanagi A. Association between depression and subjective cognitive complaints in 47 low- and middle-income countries. J Psychiatr Res 2022; 154:28-34. [PMID: 35926423 DOI: 10.1016/j.jpsychires.2022.07.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 06/13/2022] [Accepted: 07/04/2022] [Indexed: 10/17/2022]
Abstract
People with depression and subjective cognitive complaints (SCC) may be at particularly high risk for developing dementia. However, to date, studies on depression and SCC are limited mainly to single high-income countries. Thus, the aim of the present study was to investigate the association between depression and SCC in adults from low- and middle-income countries (LMICs). Cross-sectional, community-based data were analyzed from the World Health Survey. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). ICD-10 Diagnostic Criteria for Research was used for the diagnosis of subsyndromal depression, brief depressive episode, and depressive episode. Multivariable linear regression was conducted to explore the associations. Data on 237,952 individuals aged ≥18 years [mean (SD) age 38.4 (16.0) years; females 50.8%] were analyzed. After adjustment for potential confounders (age, sex, education, anxiety), compared to no depressive disorder, subsyndromal depression (b-coefficient 7.91; 95%CI = 5.63-10.18), brief depressive episode (b-coefficient 10.37; 95%CI = 8.95-11.78), and depressive episode (b-coefficient 13.57; 95%CI = 12.33-14.81) were significantly associated with higher mean SCC scores. The association was similar in all age groups (i.e., 18-44, 45-64, and ≥65 years), and both males and females. All depression types assessed were associated with worse SCC among adults in 47 LMICs. Future longitudinal studies are needed to investigate whether older people with depression and SCC are at higher risk for dementia onset in LMICs.
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Affiliation(s)
- Lee Smith
- Cambridge, Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, 03372, South Korea
| | - Tae-Jin Song
- Department of Neurology, Ewha Womans University, South Korea
| | - Benjamin R Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust, The Gnodde Goldman Sachs Translational Neuroscience Unit, University of Cambridge, Cambridge, UK
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 08830, Barcelona, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78000, Versailles, France
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain.
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, 90007, USA
| | - Nicola Veronese
- Department of Internal Medicine and Geriatrics, University of Palermo, 90133, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Bezmialem Vakif University, 34093, Istanbul, Turkey
| | - Laurie Butler
- Cambridge, Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Cambridge, Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 08830, Barcelona, Spain; ICREA, Pg, Lluis Companys 23, 08010, Barcelona, Spain
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10
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Smith L, Pardhan S, Gorely T, Barnett Y, Jacob L, López-Sánchez GF, Tully MA, Il Shin J, Koyanagi A. Physical activity and visual difficulties in 36 low- and middle-income countries. Eye (Lond) 2022; 36:585-593. [PMID: 33767410 PMCID: PMC8873357 DOI: 10.1038/s41433-021-01439-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 01/04/2021] [Accepted: 01/27/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Data on the association between visual difficulty and physical activity (PA) from low- and middle-income countries (LMICs) are scarce. Thus, the aim of the study was to investigate the association between visual difficulty and PA among adults from 36 LMICs, and to assess the mediators in this association. METHODS Cross-sectional, community-based, predominantly nationally representative data from the World Health Survey were analysed. The final sample included 199,110 individuals aged ≥18 years [mean (SD) age 38.6 (16.1) years; 49.4% males]. Visual difficulty referred to having severe/extreme difficulties in seeing and recognizing a person that the participant knows across the road. Low PA was defined as not complying with PA recommendations of 150 min of moderate-vigorous PA per week. Multivariable logistic regression, meta-analysis, and mediation analysis were conducted to assess associations. RESULTS Meta-analysis based on country-wise multivariable logistic regression analysis showed that overall, visual difficulty is associated with a 1.53 (95% CI = 1.38-1.71) times higher odds for low PA. Particularly strong associations were observed in males (OR = 1.72; 95% CI = 1.45-2.05) and adults aged ≥65 years (OR = 1.95; 95% CI = 1.67-2.29). Interpersonal activities, cognition, and sleep/energy explained >10% of the association between visual difficulty and low PA. CONCLUSIONS In conclusion, we found evidence that especially in the case of males and older adults with visual difficulties in LMICs, there were low levels of engagement with PA. Addressing issues such as interpersonal activities, cognition, and sleep/energy in people with visual difficulties may increase levels of PA.
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Affiliation(s)
- Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK.
| | - Shahina Pardhan
- grid.5115.00000 0001 2299 5510Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, UK
| | - Trish Gorely
- grid.23378.3d0000 0001 2189 1357Department of Nursing and Midwifery, University of the Highlands and Islands, Inverness, UK
| | - Yvonne Barnett
- grid.5115.00000 0001 2299 5510Anglia Ruskin University, Cambridge, UK
| | - Louis Jacob
- grid.12832.3a0000 0001 2323 0229Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France ,grid.425902.80000 0000 9601 989XICREA, Pg. Lluis Companys 23, Barcelona, Spain
| | - Guillermo F. López-Sánchez
- grid.5115.00000 0001 2299 5510Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, UK
| | - Mark A. Tully
- grid.12641.300000000105519715Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - Jae Il Shin
- grid.15444.300000 0004 0470 5454Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ai Koyanagi
- grid.425902.80000 0000 9601 989XICREA, Pg. Lluis Companys 23, Barcelona, Spain ,grid.466982.70000 0004 1771 0789Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain
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11
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Smith L, Shin JI, Oh H, López Sánchez GF, Underwood B, Jacob L, Veronese N, Soysal P, Butler L, Barnett Y, Tully MA, Koyanagi A. Anxiety symptoms among informal caregivers in 47 low- and middle-income countries: A cross-sectional analysis of community-based surveys. J Affect Disord 2022; 298:532-539. [PMID: 34788685 DOI: 10.1016/j.jad.2021.11.029] [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: 10/03/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND There are no multi-country studies on the association between informal caregiving and anxiety from low- and middle-income countries (LMICs). Therefore, we investigated this relationship in a large predominantly nationally representative sample from 47 LMICs. METHODS Cross sectional data from the World Health Survey were analyzed. Anxiety symptoms referred to severe or extreme problems with worries or anxiety in the past 30 days. Information on caregiving in the past 12 months was obtained. Multivariable logistic regression analysis adjusting for age, sex, marital status, education, household size, employment, disability, and country was conducted. Data on 237,952 individuals aged ≥18 years [mean (SD) age 38.4 (16.0) years; 50.8% female] were analyzed. RESULTS After adjustment for potential confounders, caregiving was positively associated with anxiety symptoms (OR = 1.52; 95%CI = 1.40, 1.65). Greater number of caregiving activities was associated with higher odds for anxiety symptoms dose-dependently, with the OR (95%CI) for engagement in 5 activities (vs. no caregiving) being 2.19 (1.86-2.58). CONCLUSION Caregiving is associated with higher odds for anxiety symptoms among adults in LMICs. Given the increasing importance of informal caregivers in long-term care provision and the fact that good health of caregivers is vital to sustain this system, interventions to address mental health of caregivers in LMICs are urgently needed.
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Affiliation(s)
- Lee Smith
- Cambridge Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA 90007, USA
| | - Guillermo F López Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK.
| | - Benjamin Underwood
- Cambridgeshire and Peterborough NHS Foundation Trust, The Gnodde Goldman Sachs Translational Neuroscience Unit, University of Cambridge, Cambridge, UK
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Barcelona, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - Nicola Veronese
- Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Bezmialem Vakif University, 34093 Istanbul, Turkey
| | - Laurie Butler
- Cambridge Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Cambridge Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Mark A Tully
- School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Newtownabbey BT15 1ED, Northern Ireland, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Barcelona, Spain; ICREA, Pg, Lluis Companys 23, 08010 Barcelona, Spain
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12
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Mental health in patients with asthma: A population-based case-control study. Respir Med 2022; 193:106758. [DOI: 10.1016/j.rmed.2022.106758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/23/2021] [Accepted: 01/25/2022] [Indexed: 11/19/2022]
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13
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Jeyagurunathan A, Abdin E, Shafie S, Sambasivam R, Yunjue Z, Chua BY, Vaingankar JA, Verma S, Ee TW, Chong SA, Subramaniam M. Asthma Prevalence and its Risk Factors Among a Multi-Ethnic Adult Population. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2021; 94:417-427. [PMID: 34602881 PMCID: PMC8461573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Asthma is a substantial global health problem characterized by chronic airway inflammation, leading to intermittent symptoms. This study aims to establish the prevalence and risk factors of asthma in a multi-ethnic adult population. Data for the study were extracted from the Singapore Mental Health Study 2016, a population-based, cross-sectional, epidemiological study of Singapore residents aged 18 years and above. The data relating to asthma prevalence was captured using the modified World Mental Health Composite International Diagnostic Interview (CIDI) version 3.0 chronic conditions checklist. The prevalence of lifetime asthma in this population was 11.9% (95% CI, 10.83-13.12). Those of Malay and Indian ethnicity (versus Chinese), ex-smokers (versus never smoked) and those who were overweight and obese (versus normal weight) were more likely to be associated with asthma. Participants belonging to the age group of 35 years and above (versus 18-34 years of age), male gender (versus female) were less likely to be associated with lifetime asthma. Asthma was also more likely to be associated with bipolar disorder. Those with current asthma (ie, those who had received treatment during the past 12 months) were significantly associated with lower health-related quality of life in the physical component score (PCS) than those without asthma. The high prevalence and association with lowered health-related quality of life makes asthma a significant public health concern. Our study's findings can help create awareness and encourage integrated approaches for managing asthma in the health sector.
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Affiliation(s)
- Anitha Jeyagurunathan
- Research Division, Institute of Mental Health (IMH),
Singapore,To whom all correspondence should be addressed:
Anitha Jeyagurunathan, MSW, Mphil, Principal Research Officer, Research
Division, Institute of Mental Health, Buangkok Green Medical Park, Singapore;
| | | | - Saleha Shafie
- Research Division, Institute of Mental Health (IMH),
Singapore
| | | | - Zhang Yunjue
- Research Division, Institute of Mental Health (IMH),
Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health (IMH),
Singapore
| | | | - Swapna Verma
- Department of Psychosis and East Region, IMH,
Singapore
| | - Tang Wern Ee
- National Healthcare Group Polyclinics, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health (IMH),
Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health (IMH),
Singapore,Saw Swee Hock School of Public Health, Singapore
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14
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Abstract
BACKGROUND Background: Growing evidence from observational studies indicates a high prevalence of anxiety in asthma. However, prevalence rates of coexisting anxiety symptoms and comorbid anxiety disorders vary widely across studies. We aimed to evaluate the associations between anxiety and asthma and provide more precise comorbidity estimates. METHODS We systematically reviewed the literature from case-controlled studies and conducted a meta-analysis to evaluate the pooled prevalence estimates and risks of anxiety symptoms and anxiety disorders in asthma individuals. Screening, data extraction, and quality assessment were undertaken following PRISMA guidelines for preferred reporting of systematic reviews and meta-analysis. A random-effects model was used to calculate pooled prevalence rates. Meta-analysis was conducted using Review Manager 5.3. Multiple databases including PubMed, ScienceDirect, PsychINFO, and PsycARTICLES were searched for publications before 1 December 2019. The review protocol was registered on PROSPERO (ref: CRD42020176028). RESULTS In total, 19 studies involving 106813 participants were included. The pooled prevalence of anxiety symptoms and anxiety disorders in individuals with asthma was 0.32 (95% CI 0.22-0.43) and 0.24 (95% CI 0.13-0.41), respectively. The risks of coexisting anxiety symptoms and comorbid anxiety disorders were significantly higher in asthma patients than in non-asthma controls indicated by OR 1.89 (95% CI 1.42-2.52; Z = 4.37; p < 0.001) and OR 2.08 (95% CI 1.70-2.56; Z = 6.97; p < 0.001), respectively. Anxiety symptoms and anxiety disorders occur at increased frequency among patients with asthma. CONCLUSIONS Our findings highlight the need for appropriate assessments for these comorbid conditions, which may help to identify a subgroup of patients who might benefit from interventions designed to reduce anxiety and enhance the quality of life.
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Affiliation(s)
- Gang Ye
- Suzhou Guangji Hospital, Suzhou, Jiangsu, China
| | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK
- University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Ruihua Hou
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK
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15
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Tel BC, Telli G, Onder S, Nemutlu E, Bozkurt TE. Investigation of the relationship between chronic montelukast treatment, asthma and depression-like behavior in mice. Exp Ther Med 2020; 21:27. [PMID: 33262813 PMCID: PMC7690246 DOI: 10.3892/etm.2020.9459] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 06/26/2020] [Indexed: 12/13/2022] Open
Abstract
In 2008, the Food and Drug Administration of the US issued a warning about the neuropsychiatric side effects of montelukast. Previous clinical studies on montelukast have reported conflicting results and, to the best of our knowledge, no experimental studies concerning these side effects had been conducted. In the current study, the effect of montelukast on depression-like behavior in an ovalbumin (OVA)-induced mouse model was investigated. A total of 3 OVA challenges were applied at 2 week intervals for the persistence of asthma. Depression-like behavior was assessed using forced swim tests following each challenge and locomotor activities were evaluated using open field tests. At the end of the current study, plasma montelukast concentrations were measured and the development of asthma and effect of montelukast treatment were histopathologically examined. Inflammation scores that were increased in the OVA mice following all challenges were indicated to be reduced by montelukast treatment. The immobility time of mice increased beginning with the first challenge and this was also reduced by montelukast treatment. Montelukast administration to the control mice did not alter immobility times. Moreover, motor activity of the OVA and montelukast-treated mice were not altered. The results indicated there was no association between chronic montelukast treatment and depression. Furthermore, the chronic administration of montelukast to non-asthmatic mice did not increase immobility. However, depressive behavior increased at all time points in the OVA mice. These results indicated that chronic montelukast treatment is not associated with depression-like behavior and confirmed the association between asthma and depression. Further studies are required to provide an improved understanding of the neuropsychiatric side effects of montelukast.
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Affiliation(s)
- Banu Cahide Tel
- Department of Pharmacology, Hacettepe University Faculty of Pharmacy, Ankara, Sihhiye 06100, Turkey
| | - Gokcen Telli
- Department of Pharmacology, Hacettepe University Faculty of Pharmacy, Ankara, Sihhiye 06100, Turkey
| | - Sevgen Onder
- Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Sihhiye 06100, Turkey
| | - Emirhan Nemutlu
- Department of Analytical Chemistry, Hacettepe University Faculty of Pharmacy, Ankara, Sihhiye 06100, Turkey
| | - Turgut Emrah Bozkurt
- Department of Pharmacology, Hacettepe University Faculty of Pharmacy, Ankara, Sihhiye 06100, Turkey
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16
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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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17
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Walker ES, Clark ML, Young BN, Rajkumar S, Benka-Coker ML, Bachand AM, Brook RD, Nelson TL, Volckens J, Reynolds SJ, L’Orange C, Africano S, Pinel ABO, Good N, Koehler K, Peel JL. Exposure to household air pollution from biomass cookstoves and self-reported symptoms among women in rural Honduras. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2020; 30:160-173. [PMID: 30760020 PMCID: PMC6692243 DOI: 10.1080/09603123.2019.1579304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/31/2018] [Indexed: 06/09/2023]
Abstract
Household air pollution from combustion of solid fuels is an important risk factor for morbidity and mortality, causing an estimated 2.6 million premature deaths globally in 2016. Self-reported health symptoms are a meaningful measure of quality of life, however, few studies have evaluated symptoms and quantitative measures of exposure to household air pollution. We assessed the cross-sectional association of self-reported symptoms and exposures to household air pollution among women in rural Honduras using stove type (traditional [n = 76]; cleaner-burning Justa [n = 74]) and 24-hour average personal and kitchen fine particulate matter (PM2.5) concentrations. The odds of prevalent symptoms were higher among women using traditional stoves vs Justa stoves (e.g. headache: odds ratio = 2.23; 95% confidence interval = 1.13-4.39). Associations between symptoms and measured PM2.5 were generally consistent with the null. These results add to the evidence suggesting reduced exposures and better health-related quality of life among women using cleaner-burning biomass stoves.
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Affiliation(s)
- Ethan S. Walker
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Maggie L. Clark
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Bonnie N. Young
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Sarah Rajkumar
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Megan L. Benka-Coker
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Annette M. Bachand
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Robert D. Brook
- Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Tracy L. Nelson
- Department of Health and Exercise Science and Colorado School of Public Health, Colorado State University, Fort Collins, CO, USA
| | - John Volckens
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Stephen J. Reynolds
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
- Mountain and Plains ERC, Denver, CO, USA
| | - Christian L’Orange
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | | | | | - Nicholas Good
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Kirsten Koehler
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jennifer L. Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
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18
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Grosso A, Pesce G, Marcon A, Piloni D, Albicini F, Gini E, Marchetti P, Battaglia S, Ferrari M, Fois A, Piccioni P, Antonicelli L, Verlato G, Corsico AG. Depression is associated with poor control of symptoms in asthma and rhinitis: A population-based study. Respir Med 2019; 155:6-12. [PMID: 31272012 DOI: 10.1016/j.rmed.2019.06.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/24/2019] [Accepted: 06/28/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although many studies have highlighted the link between asthma/rhinitis and depression, it is still unclear which characteristics of these diseases are associated with the risk of depression. We aimed to explore the relationship between depression and asthma or rhinitis in a representative sample of the Italian general population. METHODS The data were collected in GEIRD, an Italian multicenter, population-based, multicase-control study. 2227 participants (age 21-86 years, female 50%) underwent standardized interviews, skin prick and lung function tests, and were divided into cases of current asthma (n = 528), rhinitis without asthma (n = 972), and controls (n = 727). Two specific questions from the Patient Health Questionnaire (PHQ-2) were asked to identify symptoms of depressed mood and anhedonia, which were used as a proxy of major depression disorder. RESULTS The prevalence of depression was 16.7%, 11.9%, and 5.1% in subjects with asthma, rhinitis and controls, respectively. Both in asthma and rhinitis, subjects with depression had worse respiratory-health related quality of life and more frequent disease-related symptoms than their non-depressed counterparts. In asthma, depression was associated with poorer disease control. In rhinitis, depression was significantly associated with a disease-related limitations in daily activities and greater risk of symptom exacerbations and prescriptions of medicines for breathing. Cases of rhinitis with depression were less likely to be atopic. CONCLUSIONS Our results suggest that rhinitis exacerbations, particularly in non-atopic subjects, and low asthma control are strongly related to the presence of depressed mood in adults from the general population.
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Affiliation(s)
- Amelia Grosso
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy.
| | - Giancarlo Pesce
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy; Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Unit of Epidemiology of Allergic and Respiratory Diseases (EPAR), F75012, Paris, France
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Davide Piloni
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
| | - Federica Albicini
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
| | - Erica Gini
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
| | - Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Salvatore Battaglia
- Department of Science and Promotion of Health and Maternal Infancy "G. D'Alessandro" (PROMISE), University of Palermo, Palermo, Italy
| | - Marcello Ferrari
- Department of Medicine, Section of Respiratory Medicine, University of Verona, Verona, Italy
| | - Alessandro Fois
- Department of Clinical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Pavilio Piccioni
- Unit of Respiratory Medicine, National Health Service, ASL TO2, Torino, Italy
| | | | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Angelo Guido Corsico
- Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy
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19
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Liao Y, Gao G, Peng Y. The effect of goal setting in asthma self-management education: A systematic review. Int J Nurs Sci 2019; 6:334-342. [PMID: 31508456 PMCID: PMC6722409 DOI: 10.1016/j.ijnss.2019.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 02/18/2019] [Accepted: 04/18/2019] [Indexed: 11/24/2022] Open
Abstract
Background Asthma self-management education combining with behavior therapy is considered to be more effective. Goal setting is a common behavior change technique used to help patients self-manage their symptoms. However, empirical evidence around its effectiveness on asthma management lacks clarity. Aims To systematically integrate and appraise the evidence for effectiveness of goal setting interventions on asthma outcomes. Methods Databases included CENTRAL, PubMed, EMBASE, CINAHL and Proquest Psychology Database were systematically searched for relevant intervention studies employing goal setting technique as a method in asthma education program for self-management. Characteristic of studies and outcomes in clinical, psychosocial and healthcare utilization outcome were extracted. Results From a total of 2641 citations, 45 full-text articles were assessed for eligibility and 9 studies met the inclusion criteria. Eight studies were randomized controlled trial and one was before-after study. None studies have a high methodological quality. Goal-setting based intervention appeared to improve symptom control, quality of life and self-efficacy in adult patients with asthma. Conclusion This systematic review highlighted the potential of a goal setting technique in the asthma self-management education. However, due to the limitations of the quality and quantity of the included literature, more rigorous studies are needed. In the future, better effective study protocol combining with goal setting approach and other behavior technique is needed to further investigate.
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Affiliation(s)
- Yaoji Liao
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Guozhen Gao
- First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yaqing Peng
- School of Nursing, Guangzhou Medical University, Guangzhou, China
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20
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Jacob L, Pizzol D, Veronese N, Stubbs B, Koyanagi A. Physical injury and depression in six low- and middle-income countries: A nationally representative study. J Affect Disord 2019; 248:99-107. [PMID: 30721800 DOI: 10.1016/j.jad.2019.01.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 01/14/2019] [Accepted: 01/19/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Studies on the association between physical injury and depression in low- and middle-income countries (LMICs) are scarce. Therefore, our goal was to analyze the association between physical injury and depression using nationally representative data from six LMICs. METHODS Cross-sectional data from the Study on Global Ageing and Adult Health (SAGE) survey (2007-2010) were analyzed (N = 42,489). Questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview were used for the endorsement of past 12-month DSM-IV depression. Any injury in our analysis referred to having experienced traffic injury or other injury in the past 12 months. Multivariable logistic regression analysis and meta-analyses were used to assess associations. RESULTS Overall, the prevalence of depression was higher among those who had any injury compared to those without injuries (9.0% vs. 3.7%). Compared to having no injury, any injury without disability was associated with a 1.72 (95%CI=1.18-2.50) times higher odds for depression, while the odds for injury with disability was much higher (OR =3.81; 95%CI=2.16-6.73). The pooled estimate (OR) for the association between any injury and depression based on a meta-analysis using country-wise estimates was 3.28 (95%CI = 1.71-6.31) and a moderate level of between-country heterogeneity was observed (I2 = 63.1%). LIMITATIONS Causality or temporal associations cannot be established due to the cross-sectional nature of the study. CONCLUSIONS Personalized mental health care to victims of physical injury may reduce risk for depression. Treating disability as the result of injuries may also be effective in the prevention of depressive disorders.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 2 avenue de la Source de la Bièvre, Montigny-le-Bretonneux 78180, France.
| | - Damiano Pizzol
- Operational Research Unit, Doctors with Africa, Mozambique
| | - Nicola Veronese
- Aging Branch National Research Council, Neuroscience Institute, Padova, Italy
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
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21
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Vargas PA, Robles E. Asthma and allergy as risk factors for suicidal behavior among young adults. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:97-112. [PMID: 29652637 DOI: 10.1080/07448481.2018.1462822] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/15/2018] [Accepted: 04/05/2018] [Indexed: 06/08/2023]
Abstract
UNLABELLED An association between allergic disease, depression and suicidality has been reported. OBJECTIVE To explore the relationships between suicidality and asthma, allergy, internet addiction, stress, sleep quality, pain/discomfort, and depression, among emerging adults. PARTICIPANTS 929 college students completed an online survey between October 2015 and April 2017. METHODS A cross-sectional study using multivariate analysis techniques was implemented. RESULTS Using structural equation modeling, we found that allergies and stress were directly related to pain/discomfort; pain/discomfort was associated to poor sleep, depression, and suicidality. Sleep quality was also affected by stress; while sleep, stress, pain/discomfort, and internet addiction were directly related to depression (all p < .05). Ultimately, four factors impacted suicidality: stress, pain/discomfort, depression, and, indirectly, sleep quality (all p < .05). Although allergy had some effects, these did not reach statistical significance (p < .09). CONCLUSION Findings suggest that allergy might impact suicidality indirectly through increased pain/discomfort, poor sleep, and depression.
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Affiliation(s)
- Perla A Vargas
- a School of Social and Behavioral Sciences, Arizona State University , Glendale , Arizona , USA
| | - Elias Robles
- a School of Social and Behavioral Sciences, Arizona State University , Glendale , Arizona , USA
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22
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Akula M, Kulikova A, Khan DA, Brown ES. The relationship between asthma and depression in a community-based sample. J Asthma 2018; 55:1271-1277. [PMID: 29336633 PMCID: PMC6212321 DOI: 10.1080/02770903.2017.1418885] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 12/07/2017] [Accepted: 12/14/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Asthma is an increasingly prevalent disease that is associated with substantial physical and financial burdens. Additionally, asthma is linked to psychiatric disorders. This study examines the relationship between asthma diagnosis, current depressive symptoms, and lifetime psychiatric disorder history in a large, community-based sample. METHODS We analyzed data from 2168 participants in the Dallas Heart Study, a large, diverse, community-based sample of people designed to be representative of the Dallas County population. Logistic regressions analyzing the relationship between asthma diagnosis and history of a psychiatric disorder, as well as between asthma diagnosis and the Quick Inventory of Depressive Symptomatology (QIDS) scores were performed, controlling for demographic data. RESULTS 13.4% of the sample had an asthma diagnosis. Asthma diagnosis was significantly associated with a history of nervous, emotional, or mental health disorder diagnosis [OR 1.810 (95% CI 1.280-2.559) p = 0.001], and with QIDS scores consistent with moderate or greater current depressive symptom severity [OR 1.586 (95%CI 1.106-2.274) p = 0.012]. The relationships were not moderated by age, gender, race, smoking status, or Body Mass Index. CONCLUSIONS A diagnosis of asthma may be associated with current clinically significant levels of depressive symptoms and a lifetime psychiatric disorder. The current report adds to the existing literature in this area by assessing both current and lifetime symptoms and by using a large and diverse population. The findings highlight the clinical importance of considering the possibility of psychiatric illness in asthma patients and suggest further research in this area is needed.
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Affiliation(s)
- Mahima Akula
- Departments of Psychiatry, The University of Texas Southwestern Medical Center; Dallas, Texas, USA
| | - Alexandra Kulikova
- Departments of Psychiatry, The University of Texas Southwestern Medical Center; Dallas, Texas, USA
| | - David A. Khan
- Internal Medicine, The University of Texas Southwestern Medical Center; Dallas, Texas, USA
| | - E. Sherwood Brown
- Departments of Psychiatry, The University of Texas Southwestern Medical Center; Dallas, Texas, USA
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23
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Han YY, Forno E, Celedón JC. Anxiety and noneosinophilic asthma among adults in the United States. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 7:1367-1369.e1. [PMID: 30395990 DOI: 10.1016/j.jaip.2018.10.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/04/2018] [Accepted: 10/18/2018] [Indexed: 01/20/2023]
Affiliation(s)
- Yueh-Ying Han
- Division of Pediatric Pulmonary Medicine, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa
| | - Erick Forno
- Division of Pediatric Pulmonary Medicine, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
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Sastre J, Crespo A, Fernandez-Sanchez A, Rial M, Plaza V, González FC, López JJ, Riaza MM, Orenes MM, Montaño PP, Toro MT, Balaguer CA, Girones MA, Martinez CB, Martín IF, Delgado PG, Calahorro MM, Carrasco GM, Pacheco RR, Tomás VV, Godoy MM, Yébenes JZ, Balza De Vallejo OV, Fernandez JA, Gonzalez TB, De Las Pozas GC, Donado CD, Angulo SD, Ortiz GG, Mañana BR, Gonzalez RB, Nieves EG, Torrado JM, Culla MD, Pla JJ, Bellfill RL, Velasco JM, Nogues EP, Ortun MR, Aguñin PR, Farre NS, Combas JV, Zubeldia IA, Hortigüela GB, Ayuso JC, Álvarez GG, Peña MH, Castro AL, Llorente PL, Martinez PM, Malanda NM, Gonzalez FG, Miguel TP, Hernandez M, Timon SJ, Carreño SP, Olbah MA, Muñoz AA, Mohedad JC, Fernandez DG, Camacho AL, Lopez CM, Gonzalez MM, Bernal SN, Pellon LF, Miguel EM, Portal FO, Rodríguez AS, Alapont MM, Raducan I, Segarra MS, Bonilla PG, Calderon PM, Rodriguez MM, Martinez RL, Pérez MM, Villarejo MM, Aparicio MB, Muíño Joga MD, Garcia-Boente LF, Paz VG, Barcala FG, Orjales RN, Castedo CR, Diaz MR, Fernandez AM, Español SA, San Francisco AR, Navarrete BA, Gomez De Cadiz LC, Rodriguez ME, Lopez JF, Jiménez ML, Caballero JL, Ceres MM, Costoya RM, García CM, Vilchez MR, Ortiz AR, Mazuecos JB, Castro AV, Arenaza BL, Mendizabal SL, Sampedro IP, Vazquez LV, De Sus JC, Villa JC, Pargada DF, Jarque JH, Patiño MC, Gomila AF, Pastrie FN, Lopez JA, Martinez PB, Ruiz De Lobera AV, Gonzalez FC, Carral CP, Racamonde AV, Del Pino MC, Sacanell JR, García IA, Mejias YA, Bausela BA, Cozar MA, Sanz PB, Bobolea I, Fernandez AB, De Santiago Delgado E, Campos RD, Uña JD, Vila AF, Cano MG, De Pedro JG, Galicia MG, De Olano DG, Barbudo BH, Viña AL, Peña AL, Martin GM, De Francisco AM, Borque RM, Moro M, Prieto MR, Frutos MR, Jimenez BR, Rodríguez M, Ribate DR, Perez FR, Hornillos JR, López PS, Martinez FS, Garrido-Lestache JS, Gambasica ZV, Albelda CV, Ramirez JA, De Luiz Martínez G, Núñez IG, De Luna FL, Sáenz De Tejada EO, Galo AP, Martinez RR, Esojo MS, Espinosa RA, Inglés MA, Mora RB, Campos MF, Arellano MP, Puebla MA, Figueroa BG, Fernández SG, Rivera JO, Purroy AT, Garazo BP, Losada SV, Villamuza YG, Bonny JC, Sintes RA, Landin JC, Paz AC, Abelaira MC, Rio FI, Sanmartín AP, Picans I, Moreira AR, Romera RT, Aznar JI, Bellido FM, Hernandez MR, Perez RG, Flores HI, Gutierrez FA, Cimbollek S, De Luque Piñana V, Gallardo JM, Garcia VM, Cuevas JO, Crespo YP, Enriquez JQ, Dominguez PS, Elias ÒS, Pamplona MM, Lara MJ, De Gregorio AM, Martin MA, Canelles MB, Baixauli EB, Serra PC, Gregori MC, Rodriguez PC, De Las Marinas Alvarez M, Palacios MD, El-Qutob López D, Giner JG, Lara SH, Martínez GJ, Santafé JL, Bayo AL, Moragon EM, Sancho IM, Lacomba JM, Sendra EN, Seisdedos LN, Bertol BO, Iniesta AR, Cubillan JR, Sánchez-Toril López F, Vinuesa AS, Gomez AA, De Frutos Arribas J, Fernandez EM, Alonso AS, Sanz CC, Fuentes MD, Sotillos MG, Arazuri NS. Anxiety, Depression, and Asthma Control: Changes After Standardized Treatment. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1953-1959. [DOI: 10.1016/j.jaip.2018.02.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 01/28/2018] [Accepted: 02/01/2018] [Indexed: 11/28/2022]
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25
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Perla A V. The link between allergic disease and depression in young adults: A structural equation modelling analysis. ACTA ACUST UNITED AC 2018. [DOI: 10.17352/2455-5460.000033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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26
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Vancampfort D, Stubbs B, Smith L, Hallgren M, Firth J, Herring MP, Probst M, Koyanagi A. Physical activity and sleep problems in 38 low- and middle-income countries. Sleep Med 2018; 48:140-147. [DOI: 10.1016/j.sleep.2018.04.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 03/26/2018] [Accepted: 04/11/2018] [Indexed: 10/16/2022]
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27
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Yamamoto-Hanada K, Ishitsuka K, Pak K, Saito M, Ayabe T, Mezawa H, Konishi M, Yang L, Matsumoto K, Saito H, Ohya Y. Allergy and mental health among pregnant women in the Japan Environment and Children's Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1421-1424.e2. [DOI: 10.1016/j.jaip.2017.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 12/01/2017] [Accepted: 12/11/2017] [Indexed: 12/16/2022]
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28
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Stubbs B, Vancampfort D, Thompson T, Veronese N, Carvalho AF, Solmi M, Mugisha J, Schofield P, Matthew Prina A, Smith L, Koyanagi A. Pain and severe sleep disturbance in the general population: Primary data and meta-analysis from 240,820 people across 45 low- and middle-income countries. Gen Hosp Psychiatry 2018; 53:52-58. [PMID: 29807277 DOI: 10.1016/j.genhosppsych.2018.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 05/19/2018] [Accepted: 05/20/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Pain and sleep disturbances are widespread, and are an important cause of a reduced quality of life. Despite this, there is a paucity of multinational population data assessing the association between pain and sleep problems, particularly among low- and middle-income countries (LMICs). Therefore, we investigated the relationship between pain and severe sleep disturbance across 45 LMICs. METHOD Community-based data on 240,820 people recruited via the World Health Survey were analyzed. Multivariable logistic regression analyses adjusted for multiple confounders were performed to quantify the association between pain and severe sleep problems in the last 30 days. A mediation analysis was conducted to explore potential mediators of the relationship between pain and severe sleep disturbance. RESULTS The prevalence of mild, moderate, severe, and extreme levels of pain was 26.0%, 16.2%, 9.1%, and 2.2% respectively, whilst 7.8% of adults had severe sleep problems. Compared to those with no pain, the odds ratio (OR, 95% CI) for severe sleep problems was 3.65 (3.24-4.11), 9.35 (8.19-10.67) and 16.84 (13.91-20.39) for those with moderate, severe and extreme pain levels respectively. A country wide meta-analysis adjusted for age and sex demonstrated a significant increased OR across all 45 countries. Anxiety, depression and stress sensitivity explained 12.9%, 3.6%, and 5.2%, respectively, of the relationship between pain and severe sleep disturbances. CONCLUSION Pain and sleep problems are highly co-morbid across LMICs. Future research is required to better understand this relationship. Moreover, future interventions are required to prevent and manage the pain and sleep disturbance comorbidity.
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Affiliation(s)
- Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom.
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
| | - Trevor Thompson
- Faculty of Education and Health, University of Greenwich, London, United Kingdom
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Andre F Carvalho
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Marco Solmi
- Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy; Department of Neurosciences, University of Padova, Padova, Italy
| | - James Mugisha
- Kyambogo University, Kampala, Uganda; Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Patricia Schofield
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - A Matthew Prina
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Department of Life Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédicaen Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
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29
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Stubbs B, Vancampfort D, Firth J, Hallgren M, Schuch F, Veronese N, Solmi M, Gaughran F, Kahl KG, Rosenbaum S, Ward PB, Carvalho AF, Koyanagi A. Physical activity correlates among people with psychosis: Data from 47 low- and middle-income countries. Schizophr Res 2018. [PMID: 28637633 DOI: 10.1016/j.schres.2017.06.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND People with schizophrenia engage in low levels of physical activity (PA). However, few large-scale studies have investigated the factors that may influence PA participation in individuals with psychosis and data from low- and middle-income countries (LMICs) is especially scarce. Thus, we investigated PA correlates in a large sample of people with a psychosis diagnosis across 47 LMICs. METHODS Cross-sectional data from the World Health Survey, restricting to those with a self-reported lifetime diagnosis of schizophrenia/psychotic disorder, was analyzed. PA was assessed by the International Physical Activity Questionnaire (IPAQ) and participants were dichotomized into those that do and do not (low PA) meet the minimum recommended PA weekly targets (≥150min). A range of socio-demographic, health behavior, and mental and physical health variables were examined using random effects logistic regression. RESULTS Overall 2407 people (mean 42.0years, 41.5% males) with schizophrenia/psychosis were included. The prevalence of low PA was 39.2% (95%CI=37.0%-41.2%). Male sex (odds ratio (OR)=1.33), increasing age, unemployment (vs. employed OR=2.50), urban setting (vs. rural OR=1.75), inadequate fruit consumption (vs. adequate fruit intake OR=3.03), depression (OR=1.33), sleep/energy disturbance, and mobility limitations were significantly associated with low PA. Marital status, education, wealth, smoking, vegetable and alcohol consumption, anxiety, cognition, pain, and chronic medical conditions were not significant correlates. CONCLUSION PA is influenced by a range of factors among people with psychosis. These correlates should be considered in interventions aiming to facilitate PA in psychotic individuals living in LMICs.
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Affiliation(s)
- Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom.
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven, Kortenberg, Belgium
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom; NICM, School of Science and Health, University of Western Sydney, Australia
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinksa Institute, Stockholm, Sweden
| | - Felipe Schuch
- Unilasalle, Canoas, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Nicola Veronese
- Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy
| | - Marco Solmi
- Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy; National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Fiona Gaughran
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover Medical School, Hannover, Germany
| | - Simon Rosenbaum
- School of Psychiatry, UNSW Australia, The Black Dog Institute, University of New South Wales, Prince of Wales Hospital, Sydney, Australia
| | - Philip B Ward
- School of Psychiatry, UNSW, Sydney, Australia; Schizophrenia Research Institute, Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - Andre F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
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30
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Koyanagi A, Stubbs B, Vancampfort D. Correlates of low physical activity across 46 low- and middle-income countries: A cross-sectional analysis of community-based data. Prev Med 2018; 106:107-113. [PMID: 29066372 DOI: 10.1016/j.ypmed.2017.10.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/09/2017] [Accepted: 10/18/2017] [Indexed: 11/24/2022]
Abstract
Physical inactivity accounts for 5.5% of all avoidable global deaths. However, a paucity of multinational studies, particularly in low- and middle-income countries (LMICs), has investigated correlates of physical activity (PA). Thus, we assessed the correlates of PA using cross-sectional, community-based data of the World Health Survey including 46 LMICs. PA was assessed by the International Physical Activity Questionnaire (IPAQ) and participants were dichotomized into those who do (≥150min moderate-vigorous PA per week) and do not (<150min=low PA) comply with the World Health Organization (WHO) PA recommendations. Multivariable logistic regression was used to assess the PA correlates. The prevalence of low PA in 206,356 persons (mean age 38.4years; 49.6% males) was 29.2% (95%CI=28.3%-30.0%). In the overall sample, female sex, not married/cohabiting, high education and wealth, unemployment, and urban setting were significant sociodemographic correlates of low PA. In terms of other correlates, inadequate fruit and vegetable intake, subsyndromal depression, worse sleep/energy and cognition, visual impairment, hearing problems and asthma were associated with not meeting the WHO recommendations. There were some variations in the correlates depending on age and sex. Interventions should be developed that operate at multiple levels of influence and take into account age- and gender-related PA patterns in order to assist people in LMICs to comply with the WHO PA recommendations. Researchers, funding bodies, practitioners and policymakers in education, mental and physical health, and urban planning have a critical role to play.
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Affiliation(s)
- Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom.
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; University Psychiatric Centre KU Leuven, Kortenberg, Belgium.
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Stubbs B, Vancampfort D, Veronese N, Thompson T, Fornaro M, Schofield P, Solmi M, Mugisha J, Carvalho AF, Koyanagi A. Depression and pain: primary data and meta-analysis among 237 952 people across 47 low- and middle-income countries. Psychol Med 2017; 47:2906-2917. [PMID: 28637534 DOI: 10.1017/s0033291717001477] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Depression and pain are leading causes of global disability. However, there is a paucity of multinational population data assessing the association between depression and pain, particularly among low- and middle-income countries (LMICs) where both are common. Therefore, we investigated this association across 47 LMICs. METHODS Community-based data on 273 952 individuals from 47 LMICs were analysed. Multivariable logistic and linear regression analyses were performed to assess the association between the International Classification of Diseases, 10th Revision depression/depression subtypes (over the past 12 months) and pain in the previous 30 days based on self-reported data. Country-wide meta-analysis adjusting for age and sex was also conducted. RESULTS The prevalence of severe pain was 8.0, 28.2, 20.2, and 34.0% for no depression, subsyndromal depression, brief depressive episode, and depressive episode, respectively. Logistic regression adjusted for socio-demographic variables, anxiety and chronic medical conditions (arthritis, diabetes, angina, asthma) demonstrated that compared with no depression, subsyndromal depression, brief depressive episode, and depressive episode were associated with a 2.16 [95% confidence interval (CI) 1.83-2.55], 1.45 (95% CI 1.22-1.73), and 2.11 (95% CI 1.87-2.39) increase in odds of severe pain, respectively. Similar results were obtained when a continuous pain scale was used as the outcome. Depression was significantly associated with severe pain in 44/47 countries with a pooled odds ratio of 3.93 (95% CI 3.54-4.37). CONCLUSION Depression and severe pain are highly comorbid across LMICs, independent of anxiety and chronic medical conditions. Whether depression treatment or pain management in patients with comorbid pain and depression leads to better clinical outcome is an area for future research.
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Affiliation(s)
- B Stubbs
- Physiotherapy Department,South London and Maudsley NHS Foundation Trust,Denmark Hill, London SE5 8AZ,UK
| | - D Vancampfort
- KU Leuven,Department of Rehabilitation Sciences,Leuven,Belgium
| | - N Veronese
- Geriatrics Division,Department of Medicine-DIMED,University of Padova,Padova,Italy
| | - T Thompson
- Faculty of Education and Health,University of Greenwich,London,UK
| | - M Fornaro
- New York Psychiatric Institute,Columbia University,New York, NY,USA
| | - P Schofield
- Faculty of Health,Social Care and Education,Anglia Ruskin University,Chelmsford,UK
| | - M Solmi
- Institute of clinical Research and Education in Medicine (IREM),Padova,Italy
| | | | - A F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group,Faculty of Medicine,Federal University of Ceará,Fortaleza, CE,Brazil
| | - A Koyanagi
- Research and Development Unit,Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Dr. Antoni Pujadas, 42,Sant Boi de Llobregat,Barcelona 08830,Spain
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Vancampfort D, Stubbs B, Koyanagi A. Physical activity correlates in people with anxiety: Data from 46 low- and middle-income countries. Gen Hosp Psychiatry 2017; 49:26-31. [PMID: 29122146 DOI: 10.1016/j.genhosppsych.2017.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/19/2017] [Accepted: 04/21/2017] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There is a lack of nationally-representative data on the correlates of physical activity (PA) among people with anxiety symptoms. Thus, we investigated PA correlates among community-dwelling adults with anxiety symptoms in 46 low- and middle-income countries (LMICs) using predominantly nationally-representative data. METHOD Cross-sectional data from the World Health Survey were analysed. PA was assessed by the International Physical Activity Questionnaire (IPAQ) and participants were dichotomised into those that do (≥150min moderate-vigorous PA) and do not (<150min) meet recommended PA weekly targets. Multivariable logistic regression was used to assess the correlates. RESULTS The analysis included 24,850 people with anxiety symptoms (43.3±16.6years; 39.7% males). The prevalence of low PA was 33.1% (95%CI=31.6%-34.6%). Older age [e.g., OR=4.57 for age≥65 vs. 18-24years], not married/cohabiting (vs. married/cohabiting OR=1.36), being in the richest quintile (vs. poorest OR=1.41), unemployed (vs. employed OR=2.18), inadequate vegetable consumption (vs. adequate OR=1.66), and poor sleep/energy, worse cognition, pain/discomfort and mobility difficulties were all significant correlates of low PA. CONCLUSIONS PA is associated with a range of factors among people with anxiety symptoms. Future interventions might target the identified correlates in order to facilitate people with anxiety to be more physically active.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; University Psychiatric Centre KU Leuven, Kortenberg, Belgium.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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Vancampfort D, Stubbs B, Firth J, Hallgren M, Schuch F, Lahti J, Rosenbaum S, Ward PB, Mugisha J, Carvalho AF, Koyanagi A. Physical activity correlates among 24,230 people with depression across 46 low- and middle-income countries. J Affect Disord 2017. [PMID: 28633049 DOI: 10.1016/j.jad.2017.06.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND There is a paucity of nationally representative data available on the correlates of physical activity (PA) among people with depression, especially in low- and middle-income countries (LMICs). Thus, we investigated PA correlates among community-dwelling adults with depression in this setting. METHODS World Health Survey data included 24,230 adults (43.1 ± 16.1 years; 36.1% male) with ICD-10 diagnoses of depression including brief depressive episode and subsyndromal depression aged ≥ 18 years from 46 LMICs. PA was assessed by the International Physical Activity Questionnaire. Participants were dichotomised into low and moderate-to-high physically active groups. Associations between PA and a range of sociodemographic, health behaviour and mental and physical health variables were examined using multivariable logistic regressions. RESULTS 34.8% of participants with depression were physically inactive. In the multivariate analyses, inactivity was associated with male sex, older age, not being married/cohabiting, high socio-economic status, unemployment, living in an urban setting, less vegetable consumption, and poor sleep/ low energy. In addition, mobility difficulties and some somatic co-morbidity were associated with not complying with the 150min per week moderate-to-vigorous PA recommendations. CONCLUSIONS The current data provide guidance for future population level interventions across LMICs to help people with depression engage in regular PA.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; University Psychiatric Centre KU Leuven, Kortenberg, Belgium.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom; NICM, School of Science and Health, University of Western Sydney, Australia
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinksa Institute, Stockholm, Sweden
| | - Felipe Schuch
- Unilasalle, Canoas, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Jouni Lahti
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Simon Rosenbaum
- Black Dog Institute, Randwick, Australia; School of Psychiatry, UNSW, Sydney, Australia
| | - Philip B Ward
- School of Psychiatry, UNSW, Sydney, Australia; Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - James Mugisha
- Kyambogo University, Kampala, Uganda; Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - André F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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Maternal depressive symptoms, maternal asthma, and asthma in school-aged children. Ann Allergy Asthma Immunol 2017; 118:55-60.e1. [PMID: 28007088 DOI: 10.1016/j.anai.2016.10.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 10/24/2016] [Accepted: 10/28/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Little is known about the joint effects of maternal asthma and maternal depression on childhood asthma. OBJECTIVE To examine whether maternal depression and maternal asthma lead to greater risk of childhood asthma than maternal asthma alone. METHODS Cross-sectional studies of children (6-14 years old) in San Juan, Puerto Rico (n = 655) and Sweden (n = 6,887) were conducted. In Puerto Rico, maternal depressive symptoms were defined using the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire. In Sweden, maternal physician-diagnosed depression was derived from national registries, and maternal depressive symptoms were defined using an abbreviated CES-D questionnaire. Childhood asthma was defined as physician-diagnosed asthma plus current wheeze (in Puerto Rico) or plus medication use (in Sweden). Logistic regression was used for multivariable analysis. RESULTS Compared with Puerto Rican children whose mothers had neither asthma nor depressive symptoms, those whose mothers had asthma but no depressive symptoms had 3.2 times increased odds of asthma (95% confidence interval [CI] = 2.1-4.8) and those whose mothers had asthma and depressive symptoms had 6.5 times increased odds of asthma (95% CI = 3.3-13.0). Similar results were obtained for maternal depression and maternal asthma in the Swedish cohort (odds ratio for maternal asthma without maternal depression = 2.8, 95% CI = 2.1-3.7; odds ratio for maternal asthma and maternal depression = 4.0, 95% CI = 1.7-9.6). Although the estimated effect of maternal asthma on childhood asthma was increased when maternal depressive symptoms (Puerto Rico) or maternal depression (Sweden) was present, there were no statistically significant additive interactions. CONCLUSION Maternal depression can further increase the risk of asthma in children whose mothers have a history of asthma.
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Stubbs B, Veronese N, Vancampfort D, Thompson T, Kohler C, Schofield P, Solmi M, Mugisha J, Kahl KG, Pillinger T, Carvalho AF, Koyanagi A. Lifetime self-reported arthritis is associated with elevated levels of mental health burden: A multi-national cross sectional study across 46 low- and middle-income countries. Sci Rep 2017; 7:7138. [PMID: 28769081 PMCID: PMC5541038 DOI: 10.1038/s41598-017-07688-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 07/12/2017] [Indexed: 12/11/2022] Open
Abstract
Population-based studies investigating the relationship of arthritis with mental health outcomes are lacking, particularly among low- and middle-income countries (LMICs). We investigated the relationship between arthritis and mental health (depression spectrum, psychosis spectrum, anxiety, sleep disturbances and stress) across community-dwelling adults aged ≥18 years across 46 countries from the World Health Survey. Symptoms of psychosis and depression were established using questions from the Mental Health Composite International Diagnostic Interview. Severity of anxiety, sleep problems, and stress sensitivity over the preceding 30 days were self-reported. Self-report lifetime history of arthritis was collected, including presence or absence of symptoms suggestive of arthritis: pain, stiffness or swelling of joints over the preceding 12-months. Multivariable logistic regression analyses were undertaken. Overall, 245,706 individuals were included. Having arthritis increased the odds of subclinical psychosis (OR = 1.85; 95%CI = 1.72–1.99) and psychosis (OR = 2.48; 95%CI = 2.05–3.01). People with arthritis were at increased odds of subsyndromal depression (OR = 1.92; 95%CI = 1.64–2.26), a brief depressive episode (OR = 2.14; 95%CI = 1.88–2.43) or depressive episode (OR = 2.43; 95%CI = 2.21–2.67). Arthritis was also associated with increased odds for anxiety (OR = 1.75; 95%CI = 1.63–1.88), sleep problems (OR = 2.23; 95%CI = 2.05–2.43) and perceived stress (OR = 1.43; 95%CI = 1.33–1.53). Results were similar for middle-income and low-income countries. Integrated interventions addressing arthritis and mental health comorbidities are warranted to tackle this considerable burden.
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Affiliation(s)
- Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, United Kingdom. .,Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom. .,Institute of clinical Research and Education in Medicine (IREM), Padova, Italy. .,Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom.
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy.,Institute of clinical Research and Education in Medicine (IREM), Padova, Italy
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
| | - Trevor Thompson
- Faculty of Education and Health, University of Greenwich, London, United Kingdom
| | - Cristiano Kohler
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Patricia Schofield
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Marco Solmi
- KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium.,Department of Neurosciences, University of Padova, Padova, Italy
| | - James Mugisha
- Kyambogo University, Kampala, Uganda.,Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover Medical School, Hannover, Germany
| | - Toby Pillinger
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom
| | - Andre F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 08830, Spain.,Instituto de Salud Carlos III, Centro de InvestigaciónBiomédicaenRed de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid, 28029, Spain
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Vancampfort D, Koyanagi A, Hallgren M, Probst M, Stubbs B. The relationship between chronic physical conditions, multimorbidity and anxiety in the general population: A global perspective across 42 countries. Gen Hosp Psychiatry 2017; 45:1-6. [PMID: 28274332 DOI: 10.1016/j.genhosppsych.2016.11.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 10/25/2016] [Accepted: 11/07/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVE This cross-sectional study assessed the association of chronic physical conditions and multimorbidity with anxiety among community-dwelling adults in 42 countries. METHOD Data were analyzed from the World Health Survey including 181,845 adults aged ≥18years. Anxiety in the past 30days and nine chronic physical conditions (angina, arthritis, asthma, chronic back pain, diabetes, edentulism, hearing problem, tuberculosis, and visual impairment) were assessed. Multivariable logistic regression analyses were conducted to explore the associations between chronic physical conditions or the number of them and anxiety. RESULTS After adjustment for confounders, most of the individual chronic physical conditions were significantly associated with anxiety. Compared to those with no physical health conditions, one condition was associated with an almost twofold increased odds of anxiety symptoms (OR=1.94; 95%CI=1.76-2.13), while this figure rose to 5.49 (3.73-8.09) in those with ≥5 conditions. CONCLUSIONS Our data suggest that increasing numbers of chronic physical conditions are associated with higher odds for anxiety. Health care providers should consider the presence of anxiety symptoms especially in individuals with physical multimorbidity.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven, Kortenberg, Belgium.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinksa Institute, Stockholm, Sweden
| | - Michel Probst
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom
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Koyanagi A, Oh H, Stubbs B, Haro JM, DeVylder JE. Epidemiology of depression with psychotic experiences and its association with chronic physical conditions in 47 low- and middle-income countries. Psychol Med 2017; 47:531-542. [PMID: 27786151 DOI: 10.1017/s0033291716002750] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND The co-existence of depression and psychotic experiences (PEs) is associated with more pronounced adverse health outcomes compared to depression alone. However, data on its prevalence and correlates are lacking in the general adult population, and there is no published data on its association with chronic physical conditions. METHOD Cross-sectional, community-based data from 201 337 adults aged ⩾18 years from 47 low- and middle-income countries from the World Health Survey were analyzed. The presence of past 12-month PE and DSM-IV depression was assessed with the Composite International Diagnostic Interview (CIDI). Information on six chronic medical conditions (chronic back pain, edentulism, arthritis, angina, asthma, diabetes) were obtained by self-report. Multivariable logistic regression analysis was performed. RESULTS The crude overall prevalence of co-morbid depression/PEs was 2.5% [95% confidence interval (CI) 2.3-2.7%], with the age- and sex-adjusted prevalence ranging from 0.1% (Sri Lanka, Vietnam) to 9.03% (Brazil). Younger age, urban setting, current smoking, alcohol consumption, and anxiety were significant correlates of co-existing depression/PEs. Co-occurring depression/PEs was associated with significantly higher odds for arthritis, angina, and diabetes beyond that of depression alone after adjusting for sociodemographics, anxiety, and country, with odds ratios (depression/PEs v. depression only) being: arthritis 1.30 (95% CI 1.07-1.59, p = 0.0086); angina 1.40 (95% CI 1.18-1.67, p = 0.0002); diabetes 1.65 (95% CI 1.21-2.26, p = 0.0017). CONCLUSIONS The prevalence of co-existing depression/PEs was non-negligible in most countries. Our study suggests that when depression/PE or a chronic condition (e.g. arthritis, angina, diabetes) is detected, screening for the other may be important to improve clinical outcomes.
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Affiliation(s)
- A Koyanagi
- Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Barcelona,Spain
| | - H Oh
- University of California Berkeley School of Public Health,Berkeley,CA,USA
| | - B Stubbs
- Physiotherapy Department,South London and Maudsley NHS Foundation Trust,Denmark Hill,London,UK
| | - J M Haro
- Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Barcelona,Spain
| | - J E DeVylder
- School of Social Work,University of Maryland,Baltimore, MD,USA
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Stubbs B, Koyanagi A, Hallgren M, Firth J, Richards J, Schuch F, Rosenbaum S, Mugisha J, Veronese N, Lahti J, Vancampfort D. Physical activity and anxiety: A perspective from the World Health Survey. J Affect Disord 2017; 208:545-552. [PMID: 27802893 DOI: 10.1016/j.jad.2016.10.028] [Citation(s) in RCA: 166] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 09/14/2016] [Accepted: 10/22/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite the known benefits of physical activity (PA) among people with anxiety, little is known about PA levels in people with anxiety at the population level. This study explored the global prevalence of anxiety and its association with PA. METHODS Cross-sectional, community-based data from the World Health Survey was analyzed. Prevalence of anxiety was estimated for 237,964 individuals (47 countries). PA was categorized as low, moderate, and high based on the International Physical Activity Questionnaire (short form). The association between PA and anxiety was assessed by multivariable logistic regression. RESULTS The overall global prevalence of anxiety was 11.4% (47 countries). Across 38 countries with available data on PA, 62.5%, 20.2%, and 17.3% of the sample engaged in high, moderate, and low levels of PA respectively. The prevalence of low physical activity in those with and without anxiety was 22.9% vs. 16.6% (p<0.001) (38 countries, n=184,920). In the pooled model adjusted for socio-demographics, depression, and country, individuals engaging in low PA (vs. high PA) had 1.32 (95% CI=1.17-1.47) times higher odds for anxiety than those with high PA. Female sex, older age, lower education and wealth, and depression were also associated with low PA. At the individual country level, there was a significant positive association between low PA and anxiety in 17 of the 38 countries. CONCLUSION Low PA levels are associated with increased prevalence of anxiety. There is a need for longitudinal research to establish the directionality of the relationships observed.
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Affiliation(s)
- Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London Box SE5 8AF, United Kingdom.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| | - Mats Hallgren
- Division of Epidemiology and Public Health Intervention Research (EPHIR), Department of Public Health Sciences, Karolinska Institutet, Solna 171 77, Sweden
| | - Joseph Firth
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Justin Richards
- School of Public Health and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Felipe Schuch
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Pós Graduação em Ciências Médicas Unilassale, Canoas, Brazil
| | - Simon Rosenbaum
- Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - James Mugisha
- Kyambogo University, Kampala, Uganda; Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Nicola Veronese
- Geriatrics Division, Department of Medicine-DIMED, University of Padova, Italy; Institute of clinical Research and Education in Medicine (IREM), Padova, Italy
| | - Jouni Lahti
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
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Stubbs B, Koyanagi A, Thompson T, Veronese N, Carvalho AF, Solomi M, Mugisha J, Schofield P, Cosco T, Wilson N, Vancampfort D. The epidemiology of back pain and its relationship with depression, psychosis, anxiety, sleep disturbances, and stress sensitivity: Data from 43 low- and middle-income countries. Gen Hosp Psychiatry 2016; 43:63-70. [PMID: 27796261 DOI: 10.1016/j.genhosppsych.2016.09.008] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 09/23/2016] [Accepted: 09/28/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Back pain (BP) is a leading cause of global disability. However, population-based studies investigating its impact on mental health outcomes are lacking, particularly among low- and middle-income countries (LMICs). Thus, the primary aims of this study were to: (1) determine the epidemiology of BP in 43 LMICs; (2) explore the relationship between BP and mental health (depression spectrum, psychosis spectrum, anxiety, sleep disturbances and stress). METHODS Data on 190,593 community-dwelling adults aged ≥18 years from the World Health Survey (WHS) 2002-2004 were analyzed. The presence of past-12 month psychotic symptoms and depression was established using questions from the Composite International Diagnostic Interview. Anxiety, sleep problems, stress sensitivity, and any BP or chronic BP (CBP) during the previous 30 days were also self-reported. Multivariable logistic regression analyses were undertaken. RESULTS The overall prevalence of any BP and CBP were 35.1% and 6.9% respectively. Significant associations with any BP were observed for subsyndromal depression [OR (odds ratio)=2.21], brief depressive episode (OR=2.64), depressive episode (OR=2.88), psychosis diagnosis with symptoms (OR=2.05), anxiety (OR=2.12), sleep disturbance (OR=2.37) and the continuous variable of stress sensitivity. Associations were generally more pronounced for chronic BP. CONCLUSION Our data establish that BP is associated with elevated mental health comorbidity in LMICs. Integrated interventions that address back pain and metal health comorbidities might be an important next step to tackle this considerable burden.
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Affiliation(s)
- Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom.
| | - Ai Koyanagi
- Research and Development Unit, ParcSanitariSant Joan de Déu, Universitat de Barcelona, FundacióSant Joan de Déu, Dr. Antoni Pujadas, 42, SantBoi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de InvestigaciónBiomédicaen Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| | - Trevor Thompson
- Faculty of Education and Health, University of Greenwich, London, United Kingdom
| | - Nicola Veronese
- Geriatrics Division, Department of Medicine-DIMED, University of Padova, Italy; Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy
| | - Andre F Carvalho
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Marco Solomi
- Institute of Clinical Research and Education in Medicine (IREM), Padova, Italy; Department of Neurosciences, University of Padova, Padova, Italy
| | - James Mugisha
- Kyambogo University, Kampala, Uganda; Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Patricia Schofield
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Theodore Cosco
- MRC Unit for Lifelong Health & Ageing, University College London, 33 Bedford Place, London WC1B 5JU, United Kingdom
| | - Nicky Wilson
- Physiotherapy Service, Kings College Hospital NHS Foundation Trust, Denmark Hill, London, United Kingdom
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
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Del Giacco SR, Cappai A, Gambula L, Cabras S, Perra S, Manconi PE, Carpiniello B, Pinna F. The asthma-anxiety connection. Respir Med 2016; 120:44-53. [PMID: 27817815 DOI: 10.1016/j.rmed.2016.09.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 09/16/2016] [Accepted: 09/20/2016] [Indexed: 12/21/2022]
Abstract
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.
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Affiliation(s)
- Stefano R Del Giacco
- Department of Medical Sciences "M. Aresu", Allergy and Clinical Immunology Unit, University of Cagliari, Cagliari, Italy.
| | - Alessandra Cappai
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Luisanna Gambula
- Department of Medical Sciences "M. Aresu", Allergy and Clinical Immunology Unit, University of Cagliari, Cagliari, Italy
| | - Stefano Cabras
- Department of Mathematics and Informatics, University of Cagliari, Cagliari, Italy; Department of Statistics, Carlos III University of Madrid, Madrid, Spain
| | - Silvia Perra
- Department of Mathematics and Informatics, University of Cagliari, Cagliari, Italy
| | - Paolo Emilio Manconi
- Department of Medical Sciences "M. Aresu", Allergy and Clinical Immunology Unit, University of Cagliari, Cagliari, Italy
| | - Bernardo Carpiniello
- Department of Public Health, Psychiatry Unit, University of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Department of Public Health, Psychiatry Unit, University of Cagliari, Cagliari, Italy
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Mims JW. Asthma: definitions and pathophysiology. Int Forum Allergy Rhinol 2016; 5 Suppl 1:S2-6. [PMID: 26335832 DOI: 10.1002/alr.21609] [Citation(s) in RCA: 327] [Impact Index Per Article: 40.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 05/22/2015] [Accepted: 06/26/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Asthma is a common condition due to chronic inflammation of the lower respiratory tract. Chronic lower airway inflammation is known to be more common in individuals that also have inflammatory disorders of the upper airway. The scientific understanding of asthma continues to improve and it is important for providers who treat upper or lower airway inflammation to be familiar with asthma's definition and pathophysiology. METHODS Articles were selected based on literature reviews through PubMed and personal knowledge of the author. The search selection was not standardized. RESULTS Asthma is a heterogenic condition that is underdiagnosed and undertreated despite that the skills needed to diagnose it are readily attainable and effective treatments are available. Providers need a working understanding of asthma in order to be proficient at managing their patients with chronic nasal or sinus inflammation. This article provides a primer focusing on the current conception asthma in terms of definition, possible etiologies, inflammatory profile, pathophysiology, subtypes, and overlapping conditions. CONCLUSION Asthma is a chronic inflammatory disorder arising from not fully understood heterogenic gene-environment interactions. It features variable airway obstruction and bronchial hyperresponsiveness. Clinically, asthmatics exhibit recurrent episodes of wheeze, cough, chest tightness, and shortness of breath.
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Affiliation(s)
- James W Mims
- Department of Otolaryngology, Wake Forest School of Medicine, Winston Salem, NC
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Kankaanranta H, Kauppi P, Tuomisto LE, Ilmarinen P. Emerging Comorbidities in Adult Asthma: Risks, Clinical Associations, and Mechanisms. Mediators Inflamm 2016; 2016:3690628. [PMID: 27212806 PMCID: PMC4861800 DOI: 10.1155/2016/3690628] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 12/01/2015] [Accepted: 12/02/2015] [Indexed: 01/07/2023] Open
Abstract
Asthma is a heterogeneous disease with many phenotypes, and age at disease onset is an important factor in separating the phenotypes. Most studies with asthma have been performed in patients being otherwise healthy. However, in real life, comorbid diseases are very common in adult patients. We review here the emerging comorbid conditions to asthma such as obesity, metabolic syndrome, diabetes mellitus type 2 (DM2), and cardiac and psychiatric diseases. Their role as risk factors for incident asthma and whether they affect clinical asthma are evaluated. Obesity, independently or as a part of metabolic syndrome, DM2, and depression are risk factors for incident asthma. In contrast, the effects of comorbidities on clinical asthma are less well-known and mostly studies are lacking. Cross-sectional studies in obese asthmatics suggest that they may have less well controlled asthma and worse lung function. However, no long-term clinical follow-up studies with these comorbidities and asthma were identified. These emerging comorbidities often occur in the same multimorbid adult patient and may have in common metabolic pathways and inflammatory or other alterations such as early life exposures, systemic inflammation, inflammasome, adipokines, hyperglycemia, hyperinsulinemia, lung mechanics, mitochondrial dysfunction, disturbed nitric oxide metabolism, and leukotrienes.
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Affiliation(s)
- Hannu Kankaanranta
- Department of Respiratory Medicine, Seinäjoki Central Hospital, 60220 Seinäjoki, Finland
- Department of Respiratory Medicine, University of Tampere, 33521 Tampere, Finland
| | - Paula Kauppi
- Department of Respiratory Medicine and Allergology, Skin and Allergy Hospital, Helsinki University Hospital and Helsinki University, 00029 Helsinki, Finland
| | - Leena E. Tuomisto
- Department of Respiratory Medicine, Seinäjoki Central Hospital, 60220 Seinäjoki, Finland
| | - Pinja Ilmarinen
- Department of Respiratory Medicine, Seinäjoki Central Hospital, 60220 Seinäjoki, Finland
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Trueba AF, Ritz T, Trueba G. The Role of the Microbiome in the Relationship of Asthma and Affective Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 874:263-88. [PMID: 26589224 DOI: 10.1007/978-3-319-20215-0_13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The effect of stress, anxiety and other affective states on inflammatory conditions such as asthma is well documented. Although several immune pathway mechanisms have been proposed and studied, they cannot fully explain the relationship. In this chapter we present a new perspective on asthma development and exacerbation that integrates findings on the role of psychological factors in asthma with the microbiome and the hygiene hypothesis in asthma development.
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Affiliation(s)
- Ana F Trueba
- Universidad San Francisco de Quito, Quito, Ecuador.
| | - Thomas Ritz
- Southern Methodist University, Dallas, TX, USA.
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Chung JH, Kim SH, Lee YW. Suicidal ideation and suicide attempts among asthma. Ann Gen Psychiatry 2016; 15:35. [PMID: 27956934 PMCID: PMC5129230 DOI: 10.1186/s12991-016-0122-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 11/19/2016] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The present study aimed to investigate the mental health status in patients with asthma and assess the effects of asthma on suicidal ideation and attempts using a representative sample from Korea. METHODS Individual-level data were obtained from 228,744 participants (6372 with asthma and 222,372 without asthma) of the 2013 Korean Community Health Survey. Demographic characteristics, socioeconomic status, physical health status, and mental health status were compared between patients with asthma and population without asthma. Multivariable logistic regression was performed to investigate the independent effects of the asthma on suicidal ideation and attempts. RESULTS A depressed mood for 2 or more continuous weeks was reported by 12.0% of subjects with asthma and 5.7% of controls (p < 0.001). Suicidal thoughts were reported by 21.4% of patients with asthma and 9.8% of controls (p < 0.001). Suicidal attempts were reported by 1.0% of the patients with asthma and 0.4% of controls (p < 0.001). Following adjustment for age, sex, income, education, job, marital status, smoking, alcohol, exercise, and presence of diabetes mellitus, hypertension, stroke, arthritis, and depression, the ORs for suicidal ideation with asthma were 1.53 (95% CI 1.42-1.65) and that for suicidal attempts was 1.32 (95% CI 1.01-1.73). CONCLUSIONS We found that asthma increased the risk for suicidal ideation and attempts, even controlling for the effects of socioeconomic status, physical health status, comorbid chronic medical diseases, and depressive mood. Our finding suggests that asthma per se may be an independent risk factor for suicidality.
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Affiliation(s)
- Jae Ho Chung
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Sun-Hyun Kim
- Department of Family Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Simgokro 100 Gil 25 Seo-gu, Incheon, 22711 Republic of Korea
| | - Yong Won Lee
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
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Koyanagi A, Stickley A. The Association between Sleep Problems and Psychotic Symptoms in the General Population: A Global Perspective. Sleep 2015; 38:1875-85. [PMID: 26085291 PMCID: PMC4667394 DOI: 10.5665/sleep.5232] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 04/24/2015] [Indexed: 12/18/2022] Open
Abstract
STUDY OBJECTIVES To assess the prevalence of sleep problems and their association with psychotic symptoms using a global database. DESIGN Community-based cross-sectional study. SETTING Data were analyzed from the World Health Organization's World Health Survey (WHS), a population-based survey conducted in 70 countries between 2002 and 2004. PATIENTS OR PARTICIPANTS 261,547 individuals aged ≥ 18 years from 56 countries. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS The presence of psychotic symptoms in the past 12 months was established using 4 questions pertaining to positive symptoms from the psychosis screening module of the Composite International Diagnostic Interview. Sleep problems referred to severe or extreme sleep problems in the past 30 days. Multivariable logistic regression was used to estimate the associations. The overall prevalence of sleep problems was 7.6% and ranged from 1.6% (China) to 18.6% (Morocco). Sleep problems were associated with significantly higher odds for at least one psychotic symptom in the vast majority of countries. In the pooled sample, after adjusting for demographic factors, alcohol consumption, smoking, and chronic medical conditions, having sleep problems resulted in an odds ratio (OR) for at least one psychotic symptom of 2.41 (95% confidence interval [CI] 2.18-2.65). This OR was 1.59 (1.40-1.81) when further adjusted for anxiety and depression. CONCLUSIONS A strong association between sleep problems and psychotic symptoms was observed globally. These results have clinical implications and serve as a basis for future studies to elucidate the causal association between psychotic symptoms and sleep problems.
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Affiliation(s)
- Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Andrew Stickley
- The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
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46
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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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Koyanagi A, Stickley A. The association between psychosis and severe pain in community-dwelling adults: Findings from 44 low- and middle-income countries. J Psychiatr Res 2015; 69:19-26. [PMID: 26343590 DOI: 10.1016/j.jpsychires.2015.07.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 07/12/2015] [Accepted: 07/17/2015] [Indexed: 12/19/2022]
Abstract
Previous studies examining the association between schizophrenia and pain have produced mixed results and data on sub-threshold psychosis or psychotic symptoms and pain are scarce. This study assessed the association between psychosis and severe pain among community-dwelling adults in 44 low- and middle-income countries (LMICs) where no data exists. Data on 235,370 adults aged ≥18 years from the World Health Survey (WHS) 2002-2004 were analyzed. The presence of past 12-month psychotic symptoms was established using four questions from the Composite International Diagnostic Interview. Participants were categorized into four mutually exclusive groups based on whether they had at least one psychotic symptom and/or a lifetime psychosis or schizophrenia diagnosis. Multivariable logistic regression was used to estimate the association between psychosis and past 30-day severe pain. The prevalence of severe pain among those with 0, 1, 2, ≥3 psychotic symptoms was 8.7%, 16.7%, 21.8%, 30.5% respectively. Compared to those with no psychotic symptoms or diagnosis, the ORs (95% CIs) were: at least one symptom without diagnosis [2.17 (1.99-2.38)]; no symptom with diagnosis [2.33 (1.71-3.17)]; at least one symptom and diagnosis [4.27 (3.20-5.71)]. Associations were partly mediated by chronic physical conditions, anxiety, and depression. Despite some limitations such as the use of a single-item question to assess pain, the results of this study suggest that individuals with psychotic symptoms or a psychosis diagnosis should be systematically assessed for pain, and if necessary, receive treatment for pain and its underlying conditions. Future research on the effect of pain management on psychosis outcome is warranted.
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Affiliation(s)
- Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - Andrew Stickley
- The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden; Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
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Wang T, Ji YL, Yang YY, Xiong XY, Wang IM, Sandford AJ, Liang ZA, He JQ. Transcriptomic profiling of peripheral blood CD4⁺ T-cells in asthmatics with and without depression. Gene 2015; 565:282-7. [PMID: 25871513 DOI: 10.1016/j.gene.2015.04.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 03/29/2015] [Accepted: 04/08/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cumulative studies have shown that asthma is associated with depression but the underlying mechanisms are poorly understood. This study aimed to determine whether asthma with depression is characterized by unique pathophysiological pathways by analyzing the global gene expression patterns of CD4(+) T-cells from asthmatics with or without depression. MATERIALS AND METHODS Four groups of subjects (non-depressive asthmatics, depressive asthmatics, depression patients, and healthy controls) consisting of 6 participants in each group were studied. Peripheral CD4(+) T-cells were isolated and the global transcriptomic profiles were defined by using the Agilent SurePrint G3 Human GE 8x60K microarray. The differences in transcriptomic profiles between asthma with or without depression, depression patients and healthy controls were examined. Pathway enrichment analyses of differentially expressed genes were performed using the Ingenuity Pathway Analysis. Selected genes were verified and correlated to the clinical characteristics. RESULTS A total of 1448 differentially expressed transcripts were identified in any of the non-depressive asthma vs. healthy control, depressive asthma vs. healthy control, or depression vs. healthy control comparisons after correction for multiple comparisons. Among these, 156 were demonstrated as differentially expressed genes only in depressive asthma vs. healthy control. Twenty significant biological pathways were identified and were involved in inflammation, metabolism, immunity, tumor and cell cycle. Increased expression of phosphoinositide-3-kinase, regulatory subunit 1 (alpha) was confirmed in depressive asthmatics and it was inversely correlated with lung function (FEV1/FVC%). CONCLUSIONS Asthmatics with depression exhibit unique pathophysiological pathways and this result may provide clues for specific molecular mechanisms underlying asthma with depression.
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Affiliation(s)
- Ting Wang
- Department of Respiratory and Critical Care Medicine, West China Medical School/West China Hospital, Chengdu, Sichuan Province, PR China
| | - Yu-Lin Ji
- Department of Respiratory and Critical Care Medicine, West China Medical School/West China Hospital, Chengdu, Sichuan Province, PR China
| | - Yin-Yin Yang
- Department of Respiratory and Critical Care Medicine, West China Medical School/West China Hospital, Chengdu, Sichuan Province, PR China
| | - Xing-Yu Xiong
- Department of Respiratory and Critical Care Medicine, West China Medical School/West China Hospital, Chengdu, Sichuan Province, PR China
| | - I-Ming Wang
- Informatics and Analysis, Merck and Co. Inc., West Point, PA, USA
| | - Andrew J Sandford
- Centre for Heart Lung Innovation, University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Zong-An Liang
- Department of Respiratory and Critical Care Medicine, West China Medical School/West China Hospital, Chengdu, Sichuan Province, PR China.
| | - Jian-Qing He
- Department of Respiratory and Critical Care Medicine, West China Medical School/West China Hospital, Chengdu, Sichuan Province, PR China.
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Choi GS, Shin YS, Kim JH, Choi SY, Lee SK, Nam YH, Lee YM, Park HS. Prevalence and risk factors for depression in Korean adult patients with asthma: is there a difference between elderly and non-elderly patients? J Korean Med Sci 2014; 29:1626-31. [PMID: 25469061 PMCID: PMC4248582 DOI: 10.3346/jkms.2014.29.12.1626] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 08/12/2014] [Indexed: 01/09/2023] Open
Abstract
Depression is an important comorbidity of asthma. However, little information is available about depression and its potential impact on asthma control in Korean adult asthma patients. We aimed to estimate the prevalence and risk factors for depression in Korean adults with persistent asthma. The 127 non-elderly (20-64 yr) and 75 elderly (≥65 yr) patients with asthma were recruited. Demographic and clinical data were extracted, and the patients completed the Asthma Specific Quality of Life (AQOL) questionnaire and asthma control test (ACT). Depression status was defined using the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Depression was more prevalent in non-elderly (18.9%) than in elderly patients with asthma (13.3%). Patients with depression were significantly younger, had lower economic status, shorter disease duration, poorer asthma control, and worse AQOL scores (P<0.05). Within the non-elderly group, younger age and shorter disease duration were significantly associated with depression (P<0.05). Within the elderly group, a higher body mass index and current smoking status were significantly associated with depression (P<0.05). The PHQ-9 score was significantly correlated with worse ACT and AQOL scores in both groups. In conclusion, depression is strongly associated with poor asthma control and quality of life in Korean adult asthma patients. Our results provide important clues that used to target modifiable factors which contribute to development of depression in asthma patients.
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Affiliation(s)
- Gil-Soon Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Yoo Seob Shin
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, 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
| | - Seon Yoon Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
| | - Soo-Keol Lee
- Department of Internal Medicine, Dong-A University School of Medicine, Busan, Korea
| | - Young-Hee Nam
- Department of Internal Medicine, Dong-A University School of Medicine, Busan, Korea
| | | | - Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
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Asthma and self-harm: a population-based cohort study in Taiwan. J Psychosom Res 2014; 77:462-7. [PMID: 25224126 DOI: 10.1016/j.jpsychores.2014.08.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 08/26/2014] [Accepted: 08/28/2014] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Few studies have investigated the relationship between asthma and suicidality-related outcomes in the world. We sought to investigate the association between asthma and risk of non-fatal self-harm in a large national sample. METHODS Cases aged 10years and over were identified from Taiwan's National Health Insurance Research Database with a new primary diagnosis of asthma (ICD-9:493) between 2000 and 2008. Case status required the presence of any inpatient diagnosis of asthma and/or at least two recorded diagnoses and 1year duration of asthma in outpatient services. These 27,781 cases were compared to 138,905 sex- and age-matched controls and both groups were followed until end of 2008 for instances of self-harm, defined as ICD-9 codes E950-E959 (self-harm causes) and E980-E989 (undetermined causes). Competing risk adjusted Cox regression analyses were applied, adjusting for sex, age, residence (urban/rural), insurance premium, episode of psychiatric disease, montelukast, Charlson comorbidity index and mortality. RESULTS Of the 166,686 subjects, 445 carried out self-harm during a mean (SD) follow-up period of 5.84 (2.35) years. Asthma (hazard ratio=1.70, 95% CI: 1.35-2.14), age, residence, episode of psychiatric disease and Charlson comorbidity index were independent risks on self-harm in the fully adjusted model. CONCLUSIONS Asthma was associated with increased risk of self-harm in this population, independent of a number of potential confounding factors including montelukast use. This reinforces the need to consider mental health in routine asthma care, and to consider asthma as a potentially important stressor in people with comorbid mental disorder.
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