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Schroeder MW, Waring ME, Fowler NR, Mace RA, Pagoto SL. Association Between Subjective Cognitive Decline and Twice-Weekly Muscle-Strengthening Activities in Middle-Aged and Older US Adults: An Analysis of the 2019 Behavioral Risk Factor Surveillance System. Am J Health Promot 2024; 38:615-624. [PMID: 38226478 PMCID: PMC11123578 DOI: 10.1177/08901171231224517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
PURPOSE Adults with subjective cognitive decline (SCD), the self-reported concern of reduced cognitive function, are recommended to do physical activity for its brain health benefits. US adults aged ≥45 with SCD are less likely to meet the American College of Sports Medicine (ACSM) aerobic activity recommendations. Their engagement in muscle-strengthening activities is unknown. We aimed to identify if US adults aged ≥45 with SCD are less likely to do twice-weekly muscle-strengthening activities compared to those without SCD. DESIGN Secondary analysis of the 2019 Behavioral Risk Factor Surveillance System (BRFSS) data. SAMPLE 114 164 respondents, representing approximately 59 million US adults aged ≥45. MEASURES SCD was indicated if the respondent reported confusion or memory loss during the past 12 months (yes/no). Respondents reported the frequency of muscle-strengthening activities, which we categorized as meeting the ACSM's recommendations (2+ times per week) or not (<2 times per week). ANALYSIS Crude and adjusted logistic regression models controlling for variables associated with SCD and muscle-strengthening activities. The models used sample weights to represent US adults in the included 31 states and Washington D.C. RESULTS US adults aged ≥45 with SCD were less likely to do twice-weekly muscle-strengthening activities than those without SCD (28.6% [SE: .8%] vs 33.5% [SE: .3%], adjusted OR, .9; 95% CI: .9-1.0). CONCLUSION Primary care providers should encourage middle-aged and older patients to engage in muscle-strengthening and aerobic activities.
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Affiliation(s)
| | - Molly E. Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Nicole R. Fowler
- Indiana University Center for Aging Research, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Center for Health Innovation and Implementation Science, Indiana Clinical and Translational Science Institute, Indianapolis, IN, USA
| | - Ryan A. Mace
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sherry L. Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
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Ma S, Xu Y, Xu S, Guo Z. The effect of physical fitness on psychological health: evidence from Chinese university students. BMC Public Health 2024; 24:1365. [PMID: 38773390 PMCID: PMC11106851 DOI: 10.1186/s12889-024-18841-y] [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: 04/11/2024] [Accepted: 05/13/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Despite frequent discussions on the link between physical and mental health, the specific impact of physical fitness on mental well-being is yet to be fully established. METHOD This study, carried out between January 2022 and August 2023, involved 4,484 Chinese University students from eight universities located in various regions of China. It aimed to examine the association between physical fitness on psychological well-being. Descriptive statistics, t-tests, and logistic regression were used to analyze the association between physical fitness indicators (e.g., Body Mass Index (BMI), vital capacity, and endurance running) and mental health, assessed using Symptom Checklist-90 (SCL-90). All procedures were ethically approved, and participants consented to take part in. RESULTS Our analysis revealed that BMI, vital capacity, and endurance running scores significantly influence mental health indicators. Specifically, a 1-point increase in BMI increases the likelihood of an abnormal psychological state by 10.9%, while a similar increase in vital capacity and endurance running decreases the risk by 2.1% and 4.1%, respectively. In contrast, reaction time, lower limb explosiveness, flexibility, and muscle strength showed no significant effects on psychological states (p > 0.05). CONCLUSION Improvements in BMI, vital capacity, and endurance running capabilities are associated with better mental health outcomes, highlighting their potential importance in enhancing overall well-being.
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Affiliation(s)
- Shuzhen Ma
- College of Public Administration, Guilin University of Technology, Guilin, 541004, China.
- Department of Sports Studies, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, 43400, Selangor, Malaysia.
| | - Yanqi Xu
- College of Materials Science and Engineering, Key Laboratory of New Processing Technology for Nonferrous Metals and Materials, Collaborative Innovation Center for Exploration of Nonferrous Metal Deposits and Efficient Utilization of Resources, Ministry of Education, Guilin University of Technology, Guilin, 541004, China
| | - Simao Xu
- College of Sports Medicine and health, Chengdu Sports University, Chengdu, 61004, China
| | - Zhicheng Guo
- Public physical education Department, Guangxi Arts and Crafts School, Liuzhou, 545005, China
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Bai L, Xu Y, Pan T, Zhang Y, Zhou X, Xu J. Leukotriene Receptor Antagonists and Risk of Neuropsychiatric Entities: A Meta-Analysis of Observational Studies. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:844-854.e9. [PMID: 36473625 DOI: 10.1016/j.jaip.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND Leukotriene receptor antagonists (LTRAs) are commonly prescribed to patients with allergic diseases. Several case reports and pharmacovigilance studies have indicated that LTRAs might increase the risk of neuropsychiatric (NP) entities. However, the results are mixed in observational studies. Thus, the association between LTRAs and NP entities remains controversial. OBJECTIVE To quantitatively evaluate the NP risk with LTRAs based on current observational studies to provide a reference for clinical practice. METHODS We systematically reviewed the literature in Medline, Embase, Web of Science, Cochrane Library, Scopus, and PsycINFO. A meta-analysis of observational studies that investigated the association between LTRA use and the risk of NP entities was performed. Odds ratios (OR) with 95% confidence intervals (CI) were used to measure the effect; heterogeneity was evaluated using I-squared (I2) statistics. Subgroup and sensitivity analyses were conducted to assess bias. RESULTS Eleven articles were included in the primary analysis. No significant association was found between LTRA use and NP entities (OR: 1.08, 95% CI: 0.93-1.24, I2 = 93.7%). In patients with allergic rhinitis (AR), a mildly increased NP risk was found (OR: 1.099, 95% CI: 1.004-1.202). The association between LTRA use and NP entities was not significant in patients with asthma (OR: 1.06, 95% CI: 0.90-1.26). LTRAs increased the risk of NP entities in a single study using data from an asthma clinic (OR: 9.00, 95% CI: 1.20-69.50), but not in studies from databases (OR: 1.07, 95% CI: 0.93-1.23). CONCLUSION At the population level, LTRAs and NP entities were unrelated. However, the association may exist in particular groups (eg, patients with AR or NP history). Subject-specific studies are required to further examine the relationship between LTRAs and NP entities and identify the underlying mechanisms.
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Affiliation(s)
- Le Bai
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yong Xu
- School of Chinese Medicine, School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Tingyu Pan
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Ying Zhang
- Department of Stomatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xianmei Zhou
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Department of Respiratory Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China.
| | - Jie Xu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Department of Respiratory Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
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Evaluation of neuropsychiatric comorbidities and their clinical characteristics in Chinese children with asthma using the MINI kid tool. BMC Pediatr 2019; 19:454. [PMID: 31752780 PMCID: PMC6873764 DOI: 10.1186/s12887-019-1834-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 11/14/2019] [Indexed: 12/13/2022] Open
Abstract
Background The mental health and quality of life in children with asthma have attracted widespread attention. This study focused on the evaluation of mental health conditions and their clinical characteristics in Chinese children with asthma. Methods A total of 261 children with asthma aged 6 to 16 years old and 261 age- and gender-matched children from the general population were recruited to participate in this study from Guizhou Provincial People’s Hospital. The parents of all subjects were interviewed using the MINI Kid and were required to finish a clinical characteristics questionnaire. Logistic regression analysis was performed to evaluate risk factors. Results The prevalence of mental health conditions in the asthma group was significantly higher than that in the control group (26.4% vs 14.6%, P < 0.001). A total of 10 mental health conditions was identified in the asthma group, the most common of which was ADHD (11.5%; 30/261), followed by oppositional defiant disorder (ODD) (10.7%; 28/261), separation anxiety disorder (6.1%; 16/261), social anxiety disorder (3.8%; 10/261), specific phobias (2.3%; 6/261), agoraphobia without panic (1.5%; 4/261), (mild) manic episodes (1.1%; 3/261), major depressive episodes (MDEs) (0.8%; 2/261), movement (tic) disorder (0.8%; 2/261), and dysthymia (0.4%; 1/261). A total of 6 neuropsychiatric conditions was detected in the control group, including ODD (5.7%; 15/261), ADHD (4.6%; 12/261), social anxiety disorder (3.1%; 8/261), seasonal anxiety disorder (SAD) (2.3%; 6/261), specific phobias (1.1%; 3/261), and agoraphobia without panic (0.4%; 1/261). The prevalence rates of ODD, ADHD, and SAD differed significantly between the two groups (P < 0.05). Multiple regression analysis revealed that severe persistent asthma (OR = 3.077, 95% CI 1.286–7.361), poor asthma control (OR = 2.005, 95% CI 1.111–3.619), and having asthma for > 3 years (OR = 2.948, 95% CI 1.580–5.502) were independent risk factors for the presence of mental health conditions in asthmatic children. Conclusions Children with asthma have a higher rate of mental health conditions than non-asthmatic children. Standardized diagnosis and treatment may help reduce the risk of neuropsychiatric conditions.
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Pate CA, Zahran HS, Bailey CM. Impaired health-related quality of life and related risk factors among US adults with asthma. J Asthma 2019; 56:431-439. [PMID: 29667453 PMCID: PMC7202887 DOI: 10.1080/02770903.2018.1466314] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 03/12/2018] [Accepted: 04/15/2018] [Indexed: 01/17/2023]
Abstract
OBJECTIVE This study assessed health-related quality of life (HRQoL) and related risk factors among adults with asthma in the United States. Using the 2015 Behavioral Risk Factor Surveillance System (BRFSS), we examined the association between four domains of impaired HRQoL and selected explanatory factors. METHODS A BRFSS sample of 39,321 adults with asthma was used in this study. We examined the association between fair/poor health, ≥ 14 mentally unhealthy days, ≥ 14 physically unhealthy days, and ≥ 14 days of activity limitation and selected explanatory variables (sex, race/ethnicity, age, annual household income, healthcare coverage, physical activity, smoking status, body mass index (BMI), having a coexisting disease, and being diagnosed with depression) using multivariable logistic regression models. RESULTS Income, physical activity status, smoking status, coexisting diseases, and depression were strongly associated with all HRQoL domains. Blacks had significantly less ≥ 14 physically unhealthy days (23.4%; aPR = 0.82 [95% confidence interval (CI): 0.72, 0.92]) and ≥ 14 days of activity limitation (18.3%; aPR = 0.81 [0.70, 0.94]) and Hispanics had significantly more fair/poor health (38.4%; aPR = 1.31 [1.18, 1.45]) than whites. Underweight and obese had significantly more fair/poor health, and underweight significantly more ≥ 14 physically unhealthy days, compared with normal weight. Adults aged 55 years or older had significantly less ≥ 14 mentally unhealthy days than adults 18-24 years. CONCLUSIONS Multiple factors were associated with impaired HRQoL. Providing strategies to address potential risk factors such as low income, physically inactive, smoker, and obese or underweight should be considered to improve HRQoL among adults with asthma.
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Affiliation(s)
- Cynthia A. Pate
- Infinite Services & Solutions, Inc. Contractor to
Division of Environmental Health Science and Practice, National Center for
Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia,
USA
| | - Hatice S. Zahran
- Division of Environmental Health Science and Practice,
National Center for Environmental Health, Centers for Disease Control and
Prevention, Atlanta, Georgia, USA
| | - Cathy M. Bailey
- Division of Environmental Health Science and Practice,
National Center for Environmental Health, Centers for Disease Control and
Prevention, Atlanta, Georgia, USA
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Kim SY, Choi SH, Kim JD, Sol IS, Kim MJ, Kim YH, Jung YC, Sohn MH, Kim KW. Korean Youth with Comorbid Allergic Disease and Obesity Show Heightened Psychological Distress. J Pediatr 2019; 206:99-104.e4. [PMID: 30466789 DOI: 10.1016/j.jpeds.2018.10.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/20/2018] [Accepted: 10/23/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To explore psychological distress in Korean adolescents having allergic disease comorbid with obesity. STUDY DESIGN A total of 703 869 adolescents who completed the Korean Youth Risk Behavior Web-based Survey between 2007 and 2016 were analyzed. Participants were divided into 4 groups-healthy control, allergic disease only, obesity only, and comorbidity of allergic disease and obesity-and compared them to determine whether they showed differences in mental health. RESULTS Adolescents with both atopic dermatitis and obesity had significantly greater odds of experiencing unhappiness (OR, 1.17), stress (OR, 1.32), and suicidal ideation (OR, 1.25) than those without both conditions. The same was true of adolescents with obesity and allergic rhinitis (OR, 1.21, 1.37, and 1.27, respectively) or bronchial asthma (OR, 1.37, 1.39, and 1.37). The comorbidity groups also showed significantly greater odds of stress and suicidal ideation than the allergic disease-only (atopic dermatitis with obesity, 1.21 and 1.15, respectively; allergic rhinitis with obesity, 1.11 and 1.09; bronchial asthma with obesity, 1.17 and 1.14) and obesity-only groups (atopic dermatitis with obesity, 1.13 and 1.09; allergic rhinitis with obesity, 1.18 and 1.10; bronchial asthma with obesity, 1.18 and 1.21). CONCLUSIONS Allergic disease and obesity negatively and additively influence mental health in adolescents.
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Affiliation(s)
- Soo Yeon Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sun Ha Choi
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong Deok Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - In Suk Sol
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Jung Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yoon Hee Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Chul Jung
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myung Hyun Sohn
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Oh H, Stickley A, Singh F, Koyanagi A. Self-reported asthma diagnosis and mental health: Findings from the Collaborative Psychiatric Epidemiology Surveys. Psychiatry Res 2019; 271:721-725. [PMID: 30791347 DOI: 10.1016/j.psychres.2018.12.046] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 12/06/2018] [Accepted: 12/06/2018] [Indexed: 12/27/2022]
Abstract
Historically, asthma has had a mixed association with mental health. More research is needed to examine the associations between asthma and specific psychiatric disorders, and whether these associations hold true across racial groups in the general population of the United States. Using the Collaborative Psychiatric Epidemiology Surveys, we examined the associations between lifetime asthma and specific DSM-IV psychiatric disorders, adjusting for sociodemographic characteristics and smoking status. We found that when looking at the entire sample, self-reported diagnosis of asthma was associated with greater odds of reporting mood disorders (AOR: 1.36; 95% CI: 1.05-1.74). Asthma was not significantly associated with total anxiety disorders (AOR 1.25; 95% CI: 0.98-1.60), though it was specifically associated with generalized anxiety disorder. Asthma was associated with greater odds of having alcohol use disorders (AOR: 1.71; 95% CI: 1.24-2.37), but was not associated with total eating disorders (AOR:1.36; 95% CI: 1.17-2.51) (though it was significantly associated with higher odds for binge eating disorder, but lower odds of reporting bulimia). The strength and the significance of the associations between asthma and psychiatric disorders varied when stratified by race, underscoring the importance of examining race as a potential explanation for the mixed findings observed previously in the literature.
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Affiliation(s)
- Hans Oh
- University of Southern California, School of Social Work, 669W. 34 th St., University of Southern California, Los Angeles, CA 90089 - 0411.
| | - Andrew Stickley
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, 141 89, Sweden; Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo 1878553, Japan
| | - Fiza Singh
- University of California, San Diego, Department of Psychiatry, 9500 Gilman Drive, La Jolla, CA 92093-0810, USA
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Deu, Barcelona, 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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Becerra BJ, Banta JE, Ghamsary M, Martin LR, Safdar N. Burden of mental illness on hospital and patient outcomes among asthma hospitalizations. J Asthma 2016; 53:392-7. [PMID: 26666294 DOI: 10.3109/02770903.2015.1124440] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Empirical evidence demonstrates the comorbidity of asthma and mental illness, though limited studies have evaluated the patient and hospital outcomes associated with such conditions. As such, this study evaluated the burden of this comorbidity on health resource utilization and patient disposition among asthma hospitalizations. METHODS A secondary analysis of the Nationwide Inpatient Sample (2009-2011) was conducted, with study population of asthma hospitalizations limited to those 18 years of age and older. International Classification of Disease, 9th Revision, Clinical Modification codes were utilized to identify asthma and mental illness discharges. Length of stay was defined as number of days stayed in the hospital, total charges were inflation-adjusted, and patient disposition was defined as routine versus not routine. All analyses were survey-weighted and adjusted for patient and hospital characteristics. RESULTS Approximately 29% of the asthma hospitalizations reported mental illness. Any mental illness was associated with increased length of stay in the hospital (10% increase), total costs (11% increase), and lower odds of routine disposition (21% decrease). Substance-related disorder also increased length of stay in the hospital (4% increase), costs (9% increase), and lower odds of routine disposition (29% decrease). Age-stratified analyses further demonstrated similar trends among most age groups. CONCLUSION The results of this study complement the extant literature by demonstrating the burden of the asthma-mental health nexus on health resource utilization and patient outcomes. The increased length of stay, cost, and decreased likelihood of routine disposition associated with mental illness highlight the need for integrated care to address mental illness as part of routine care.
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Affiliation(s)
- Benjamin J Becerra
- a School of Public Health, Loma Linda University , Loma Linda , CA , USA .,b School of Allied Health Professions, Loma Linda University , Loma Linda , CA , USA
| | - Jim E Banta
- a School of Public Health, Loma Linda University , Loma Linda , CA , USA
| | - Mark Ghamsary
- a School of Public Health, Loma Linda University , Loma Linda , CA , USA
| | - Leslie R Martin
- c Department of Psychology , La Sierra University , Riverside , CA , USA , and
| | - Nasia Safdar
- d Department of Medicine , University of Wisconsin , Madison , WI , USA
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Becerra MB, Becerra BJ, Safdar N. A nationwide assessment of asthma-mental health nexus among veterans. J Asthma 2015; 53:164-9. [PMID: 26549507 DOI: 10.3109/02770903.2015.1086785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE In this study, we evaluated the association between both current and lifetime asthma to that of mental illness among veterans in the USA. METHODS We utilized the 2005-2013 National Survey on Drug Use and Health data, a national population-based survey in the USA. Mental illness was defined as past year major depressive episode and doctor diagnosis of depression. Survey-weighted univariate and multivariable regression analyses were utilized. A total of 20,581 veterans were included in the study. RESULTS A 4.00% and 7.50% prevalence of current and lifetime asthma were noted among veterans, respectively. A significantly higher prevalence of major depressive episode was noted among veterans with current asthma (8.23%), as compared to those without (4.68%), with a similar trend noted among those with lifetime asthma versus those without (7.84% vs. 4.58%). Doctor diagnosis of depression among veterans was higher among those with current asthma (11.83% vs. 5.86%) and lifetime asthma (10.32% vs. 5.76%), as compared to those without asthma. Upon adjusting for confounders, current asthma was significantly associated with past year major depressive episode [adjusted odds ratio (aOR) = 1.65) and depression diagnosis (aOR = 1.88). Similarly, veterans with lifetime asthma, as compared to those without, had higher odds of past year major depressive episode (aOR = 1.56) and depression diagnosis (aOR = 1.66). CONCLUSION The asthma/mental health nexus is significant among the US veterans. Such results warrant the need for integrated care to address mental health burden among veterans with asthma.
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Affiliation(s)
| | - Benjamin J Becerra
- b School of Allied Health Professions, Loma Linda University , Loma Linda , CA , USA , and
| | - Nasia Safdar
- c School of Medicine, University of Wisconsin , Madison , WI , USA
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Arif AA, Korgaonkar P. The association of childhood asthma with mental health and developmental comorbidities in low-income families. J Asthma 2015; 53:277-81. [PMID: 26365092 DOI: 10.3109/02770903.2015.1089277] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The objective of the study was to determine the relationship of childhood asthma with mental health and developmental indicators in low-income families. METHODS Parents/guardians of approximately 400 children, aged 2-14 years, were recruited from a charity hospital serving low income neighborhoods in the outskirts of Karachi, Pakistan. Mothers of children were interviewed in their local language by a trained nurse. Eight self-reported comorbidities were grouped into two constructs based on factor analysis and conveniently labeled as mental health (anxiety, attention and behavioral problems) and developmental problems (learning, developmental delay, hearing impairment, sleep and speech problems). Data were analyzed using multiple logistic regression, adjusted for age, sex, presence of older siblings, number of people in the household, child birth weight, presence of mold, and family history of asthma or hay fever. RESULTS Children with asthma had 18 times greater odds of mental health problems (adjusted OR = 18.0, 95% CI: 9.2, 35.1) as compared to children without asthma. The odds of developmental problems were more than 14 times greater for children with asthma (adjusted OR = 14.3, 95% CI: 7.8, 26.1) as compared to children without asthma. CONCLUSIONS This study found mental and developmental adverse consequences of childhood asthma in low-income families. Identifying and treating asthma at an early age could reduce the burden of comorbidities in this population.
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Affiliation(s)
- Ahmed A Arif
- a Department of Public Health Sciences , University of North Carolina at Charlotte , Charlotte , NC , USA
| | - Purva Korgaonkar
- a Department of Public Health Sciences , University of North Carolina at Charlotte , Charlotte , NC , USA
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Boudreau M, Lavoie KL, Cartier A, Trutshnigg B, Morizio A, Lemière C, Bacon SL. Do asthma patients with panic disorder really have worse asthma? A comparison of physiological and psychological responses to a methacholine challenge. Respir Med 2015; 109:1250-6. [PMID: 26383174 DOI: 10.1016/j.rmed.2015.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 07/30/2015] [Accepted: 09/03/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Panic disorder (PD) has been linked to worse asthma outcomes. Some suggest that asthmatics with PD have worse underlying asthma; others argue that worse outcomes are a result of their tendency to over-report symptoms. This study aimed to measure physiological and psychological responses to a simulated asthma attack (methacholine challenge test: MCT) in asthmatics with and without PD. METHODS Asthmatics with (n = 19) and without (n = 20) PD were recruited to undergo a MCT. Patients completed subjective symptom questionnaires (Panic Symptom Scale, Borg Scale) before and after a MCT. Physiological measures including heart rate (HR), and systolic and diastolic blood pressure (SBP/DBP) were also recorded. RESULTS Analyses, adjusting for age and sex, revealed no difference in methacholine concentration required to induce a 20% drop in forced expiratory volume in one second (FEV1: F = 0.21, p = .652). However, PD patients reported worse subjective symptoms, including greater ratings of dyspnea (F = 8.81, p = .006) and anxiety (F = 9.44, p = .004), although they exhibited lower levels of physiological arousal (i.e., HR, SBP/DBP). An interaction effect also indicated that PD, relative to non-PD, patients reported more panic symptoms post-MCT (F = 5.05, p = .031). CONCLUSIONS Asthmatics with PD report higher levels of subjective distress, despite exhibiting lower levels of physiological arousal, with no evidence of greater airway responsiveness. Results suggest that worse outcomes in PD patients may be more likely due to a catastrophization of bodily symptoms, rather than worse underlying asthma. Interventions designed to educate patients on how to distinguish and manage anxiety in the context of asthma are needed.
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Affiliation(s)
- Maxine Boudreau
- Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin West, Montréal, Québec, H4J 1C5, Canada; Department of Psychology, University of Quebec at Montreal (UQAM), P.O. Box 8888, Succursale Center-Ville, Montreal, Quebec, H3C 3P8, Canada
| | - Kim L Lavoie
- Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin West, Montréal, Québec, H4J 1C5, Canada; Department of Psychology, University of Quebec at Montreal (UQAM), P.O. Box 8888, Succursale Center-Ville, Montreal, Quebec, H3C 3P8, Canada; Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - André Cartier
- Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - Barbara Trutshnigg
- Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin West, Montréal, Québec, H4J 1C5, Canada
| | - Alexandre Morizio
- Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin West, Montréal, Québec, H4J 1C5, Canada; Department of Exercise Science, Concordia University, 7141 Sherbrooke St. West, Montreal, Quebec, H4B 1R6, Canada
| | - Catherine Lemière
- Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - Simon L Bacon
- Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin West, Montréal, Québec, H4J 1C5, Canada; Department of Exercise Science, Concordia University, 7141 Sherbrooke St. West, Montreal, Quebec, H4B 1R6, Canada.
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Asthma deaths in a large provincial health system. A 10-year population-based study. Ann Am Thorac Soc 2015; 11:1210-7. [PMID: 25166217 DOI: 10.1513/annalsats.201404-138oc] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Individuals with asthma are more likely to die from chronic conditions than the general population. Measuring only mortality with asthma listed as the primary cause of death may lead to an underestimation of total asthma mortality. OBJECTIVES To examine mortality patterns in the asthma population over 10 years, including asthma as the primary cause of death (asthma-specific mortality) and asthma as a secondary, contributing cause of death (asthma-contributing mortality). METHODS Health administrative data from Ontario, Canada were used to identify mortality rates and cause of death in subjects 0 to 99 years of age. Mortality rates were calculated in the asthma and general population from 1999 to 2008. Total asthma mortality was estimated by adding rates of asthma-specific and asthma-contributing mortality for years 2003 to 2008. MEASUREMENTS AND MAIN RESULTS Asthma-specific mortality rates per 100,000 asthma population decreased by 54.4% from 13.6 in 1999 to 6.2 in 2008. In 2008, the asthma population had higher all-cause mortality compared with the general population (rate ratio, 1.3), asthma-specific mortality rates were 60% higher among those in the lowest compared with highest socioeconomic status, and total asthma mortality was fourfold higher than asthma-specific mortality alone (21.6 vs. 5.4 per 100,000). CONCLUSIONS All-cause mortality rates have decreased substantially over the past decade. Compared with the general population, the asthma population has higher all-cause mortality and is more likely to die from comorbid conditions. Total asthma mortality was fourfold higher than asthma-specific mortality, highlighting the importance of comprehensive measurement approaches that include asthma-specific and asthma-contributing mortality.
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Arias D, Becerra BJ, Becerra MB. Racial and ethnic differences in asthma and mental health among US adults: results from the National Survey on Drug Use and Health. J Asthma 2015; 52:715-20. [PMID: 25584661 DOI: 10.3109/02770903.2015.1005843] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Evaluate the racial and ethnic differences in asthma and mental health comorbidity. METHODS A secondary analysis of 2008-2013 National Survey on Drug Use and Health was conducted, resulting in a total of 206 993 civilian adult respondents to evaluate the association between asthma and mental health (past year serious psychological distress [SPD] and doctor diagnosis of depression). Both survey weighted bivariate (chi-square) and multivariable (binary logistic) regression analyses, after accounting for control variables, were conducted to evaluate the asthma/mental health nexus. A p value of less than 0.05 was used to denote significance. RESULTS Current asthma was significantly associated with past year SPD for non-Hispanic Whites (adjusted odds ratio [aOR] = 1.45), Hispanics (aOR = 1.68), and Black/African Americans (aOR = 1.47). A similar association was noted for current asthma and past year doctor diagnosis of depression (non-Hispanic White aOR = 1.74; Hispanics aOR = 1.77; Black/African American aOR = 1.62). Among those with lifetime asthma, higher odds of SPD were reported for non-Hispanic Whites (aOR = 1.42), Hispanics (aOR = 1.64), and Black/African Americans (aOR = 1.50). Lifetime asthma also significantly associated with past year doctor diagnosis of depression for non-Hispanic Whites (aOR = 1.42), Hispanics (aOR = 1.41), and Black/African Americans (aOR = 1.46). CONCLUSION Our results demonstrate the significant burden of asthma and mental health comorbidity among diverse racial and ethnic groups. Improved public health efforts through promotion of integrated care for early screening and preventive measures are needed to alleviate the burden for at-risk groups.
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Affiliation(s)
- Devin Arias
- a Department of Health Science and Human Ecology , California State University , San Bernardino , CA , USA
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Association between asthma and serious psychological distress among male veterans compared to civilian counterparts. Prev Med 2015; 71:8-11. [PMID: 25482421 DOI: 10.1016/j.ypmed.2014.11.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Revised: 11/28/2014] [Accepted: 11/29/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Identify the association between current asthma status and serious psychological distress among males who served in the U.S. Armed Forces as compared to civilians. METHODS A secondary analysis was performed utilizing the 2009 and 2011 California Health Interview Survey, including 9993 veteran males and 26,999 civilian males. All analyses used replicate weights to account for complex survey design. Descriptive statistics and chi-square analyses were generated to describe the population. Multivariable logistic regression analyses were utilized to model the effect of asthma and other covariates on past year and past month serious psychological distress, stratified by veteran status. RESULTS After model adjustment, current asthma status was significantly associated with past month and year serious psychological distress among veterans only. In addition, while race/ethnicity and risk behaviors of smoking and/or binge drinking were significantly associated with distress among civilians, no such association was noted among veterans. CONCLUSION To the authors' knowledge, this was the first study to demonstrate that the relationship between asthma and serious psychological distress varies by veteran status. Several unique correlates among veterans were also noted. Future preventive strategies for mental health disorders should incorporate these reported differences, including that of asthma co-morbidity among veterans.
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Brunner WM, Schreiner PJ, Sood A, Jacobs DR. Depression and risk of incident asthma in adults. The CARDIA study. Am J Respir Crit Care Med 2014; 189:1044-51. [PMID: 24456492 PMCID: PMC4098106 DOI: 10.1164/rccm.201307-1349oc] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 01/21/2014] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Asthma is associated with depression, but the temporality of the association has not been established. OBJECTIVES To examine the association between prevalent elevated depressive symptoms and incident asthma, and between prevalent asthma and incident elevated depressive symptoms in a cohort of young and middle-aged adults. METHODS We examined the longitudinal association between asthma and depressive symptoms bidirectionally in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort. First, 3,614 participants, free of asthma, were classified by elevated depressive symptoms at the CARDIA Year-5 exam (n = 856 elevated vs. 2,758 not elevated; ages 23-35 yr) and followed for 20 years to incident asthma. Then, 3,016 participants, free of elevated depressive symptoms, were classified by self-reported current asthma status (n = 188 prevalent vs. 2,828 not prevalent) at the CARDIA Year-5 exam and followed for 20 years until onset of elevated depressive symptoms. MEASUREMENTS AND MAIN RESULTS The relative hazard of incident asthma among those with elevated depressive symptoms was 1.26 (95% confidence interval [CI] = 1.02-1.56) after adjustment for covariates. When depressive status was modeled as the total number of reports of elevated depressive symptoms before the onset of asthma, the adjusted hazard ratio was 1.15 (95% CI = 1.02-1.29). The hazard of incident elevated depressive symptoms for those with asthma was no different than the hazard in those without asthma (adjusted hazard ratio = 0.92; 95% CI = 0.70-1.20). CONCLUSIONS This longitudinal observational study points to depression as a marker of risk for incident adult-onset asthma. On the other hand, prevalent asthma is not associated with incident adult-onset depression.
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Affiliation(s)
- Wendy M Brunner
- 1 Asthma Program, Chronic Disease and Environmental Epidemiology Section, Minnesota Department of Health, St. Paul, Minnesota
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Bhan N, Glymour MM, Kawachi I, Subramanian SV. Childhood adversity and asthma prevalence: evidence from 10 US states (2009-2011). BMJ Open Respir Res 2014; 1:e000016. [PMID: 25478171 PMCID: PMC4212798 DOI: 10.1136/bmjresp-2013-000016] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 02/04/2014] [Accepted: 02/06/2014] [Indexed: 01/25/2023] Open
Abstract
Background Existing evidence on stress and asthma prevalence has disproportionately focused on pregnancy and postpregnancy early life stressors, largely ignoring the role of childhood adversity as a risk factor. Childhood adversity (neglect, stressful living conditions and maltreatment) may influence asthma prevalence through mechanisms on the hypothalamic-pituitary axis. Methods Data from the Center for Disease Control's (CDC's) Behavioral Risk Factor Surveillance System (BRFSS) surveys were used to examine cross-sectional associations of adverse childhood experiences (ACE) with lifetime and current asthma prevalence. Information on childhood adversity was available from 84 786 adult respondents in 10 US states. Poisson regression models (with robust SE) were used to estimate prevalence ratios (PRs) relating overall ACE score and dimensions of exposure ACE to asthma prevalence, adjusting for socioeconomic status. Results Greater ACE was associated with a higher prevalence of asthma (adjusted PRcat 4=1.78 (95% CI 1.69 to 1.87), adjusted PRcat 1=1.21 (95% CI 1.16 to 1.27)). Reported experiences of sexual abuse (adjusted PR=1.48* (1.42 to 1.55)) and physical abuse (adjusted PR=1.38* (1.33 to 1.43)) were associated with a higher asthma prevalence. No clear socioeconomic gradient was noted, but those reporting lowest education and income levels reported high rates of asthma and adversity. Sensitivity analyses indicated that ACE exposures were interrelated. Conclusions Report of childhood adversity predicts asthma prevalence among US adults. Frameworks for asthma prevention need to recognise and integrate aspects related to childhood adversity. Further investigation into specific time periods of exposure would provide meaningful inferences for interventions.
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Affiliation(s)
- Nandita Bhan
- South Asia Network for Chronic Diseases, Public Health Foundation of India , New Delhi , India
| | - M Maria Glymour
- Department of Epidemiology & Biostatistics , UCSF School of Medicine , San Francisco, California , USA
| | - Ichiro Kawachi
- Department of Social & Behavioral Sciences , Harvard School of Public Health , Boston, Massachusetts , USA
| | - S V Subramanian
- Department of Social & Behavioral Sciences , Harvard School of Public Health , Boston, Massachusetts , USA
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17
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Asthma and depression: the Cooper Center Longitudinal Study. Ann Allergy Asthma Immunol 2014; 112:432-6. [PMID: 24650441 DOI: 10.1016/j.anai.2014.02.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 02/21/2014] [Accepted: 02/25/2014] [Indexed: 01/10/2023]
Abstract
BACKGROUND Prior research suggests a possible association between asthma and depression. OBJECTIVE To examine the association between asthma and depressive symptoms, controlling for asthma medications, lung function, and overall health. METHODS We conducted a cross-sectional study of 12,944 adults who completed physician-based preventive health examinations at the Cooper Clinic from 2000 to 2012. Information on medical histories, including asthma and depression, and medications were collected. Participants reported overall health status, completed spirometry testing, and underwent depression screening using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D). Dependent variables of current depressive symptoms (CES-D scores ≥10) and lifetime history of depression were separately modeled using logistic regression with independent variables, including demographics, spirometry, asthma controller medications, and patient-reported health status. RESULTS The sample was predominantly white and well educated. The prevalence of asthma was 9.0%. Asthma was associated with an odds ratio (OR) of 1.41 (95% CI, 1.16-1.70; P < .001) of current depressive symptoms based on CES-D score. Asthma was also associated with lifetime history of depression (OR, 1.66; 95% CI, 1.40-1.95; P < .001). Neither lung function nor asthma controller medications were significantly associated with depression. CONCLUSION Asthma was associated with increased prevalence of current depressive symptoms and lifetime depression in a large sample of relatively healthy adults. These findings suggest that the increased likelihood of depression among patients with asthma does not appear to be exclusively related to severe or poorly controlled asthma. People with asthma, regardless of severity, may benefit from depression screening in clinical settings.
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18
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Sanna L, Stuart AL, Pasco JA, Jacka FN, Berk M, Maes M, O'Neil A, Girardi P, Williams LJ. Atopic disorders and depression: findings from a large, population-based study. J Affect Disord 2014; 155:261-5. [PMID: 24308896 DOI: 10.1016/j.jad.2013.11.009] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 11/10/2013] [Accepted: 11/12/2013] [Indexed: 01/04/2023]
Abstract
BACKGROUND Atopy, a common disorder characterized by a sensitivity to allergic reactions, affects a large proportion of the adult population and, as with depression, is associated with immune-inflammatory pathway changes. We sought to determine the role of atopic disorders in depression using data from a randomly-selected, population-based study of men and women. METHODS Cross-sectional data derived from the Geelong Osteoporosis Study for 942 males and 1085 females were analyzed. Depression [major depressive disorder (MDD), minor depression and dysthymia] was assessed using the Structured Clinical Interview for DSM-IV-TR Research Version, Non-patient edition. Data on medical conditions, including atopic disorders (asthma, hay fever and eczema), smoking status, alcohol consumption, socioeconomic status, and physical activity were documented by self-report. Logistic regression modeling was used to explore the associations between atopic disorders and depression. RESULTS Atopic disorders were associated with a 59% increased likelihood of depression [gender and smoking-adjusted odds ratio (OR) 1:50, 95% CI 1.20-1.97]. Sub-group analyses revealed a similar pattern for those with MDD [gender and smoking-adjusted OR 1:54, 95% CI 1.22-1.94]. These associations were independent of socio-demographic characteristics, clinical and lifestyle factors. LIMITATIONS Reliance on self-report for allergic symptoms and cross-sectional nature of study. CONCLUSION This population-based study provides evidence of the potential contribution of allergic disorders to depression. Further research is required to elucidate the direction of this association and to further explicate its underlying physiology, including immune-inflammation markers.
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Affiliation(s)
- Livia Sanna
- Neurosciences, Mental Health and Sensory Organs Department (NeSMOS), Unit of Psychiatry, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Italy; School of Medicine, Deakin University, Geelong, Australia.
| | | | - Julie A Pasco
- School of Medicine, Deakin University, Geelong, Australia; Division of Medicine, Barwon Health, Geelong, Australia; NorthWest Academic Centre, Department of Medicine, The University of Melbourne, Western Health, St Albans, Australia.
| | - Felice N Jacka
- School of Medicine, Deakin University, Geelong, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Australia.
| | - Michael Berk
- School of Medicine, Deakin University, Geelong, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Australia; Orygen Youth Health Research Centre, Parkville, Australia; Florey Institute for Neuroscience and Mental Health, Parkville, Australia.
| | - Michael Maes
- School of Medicine, Deakin University, Geelong, Australia.
| | - Adrienne O'Neil
- School of Medicine, Deakin University, Geelong, Australia; School of Public Health and Preventive Medicine, Monash University, Prahran, Australia.
| | - Paolo Girardi
- Neurosciences, Mental Health and Sensory Organs Department (NeSMOS), Unit of Psychiatry, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Italy.
| | - Lana J Williams
- School of Medicine, Deakin University, Geelong, Australia; Department of Psychiatry, The University of Melbourne, Parkville, Australia.
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Yii ACA, Koh MS. A review of psychological dysfunction in asthma: affective, behavioral and cognitive factors. J Asthma 2013; 50:915-21. [PMID: 23808821 DOI: 10.3109/02770903.2013.819887] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The research on psychological dysfunction in asthma is extensive but heterogeneous. We undertook a narrative review about the effects of psychological dysfunction on asthma. METHODS Electronic searches of MEDLINE, EMBASE, CINAHL and the Cochrane Library were conducted, supplemented by hand-searching bibliographies and seeking expert opinion. RESULTS The impact of psychological factors on asthma can be classified according to dysfunction in the domains of affect, behavior and cognition. Affective or emotional disturbance may lead to poor asthma control by directly modulating disease activity. Maladaptive behaviors may occur in asthma patients. These include maladaptive breathing behaviors, such as impaired voluntary drive to breathe and dysfunctional breathing, as well as impaired asthma health behaviors, that is, a coordinated range of activities performed to maintain good disease control. Dysfunctional cognitions (thoughts and beliefs) about asthma and impaired cognitive processing of the perception of dyspnea are associated with poorly controlled disease and asthma deaths, respectively. The three domains of psychological dysfunction are often closely intertwined, leading to vicious circles. CONCLUSIONS We have conceptualized psychological dysfunction in asthma using a framework consisting of affect, behavior and cognition. Their influences are intertwined and complex. Future research should focus on the formulation of a psychological assessment tool based on this framework and evaluating its efficacy in improving asthma outcomes.
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Affiliation(s)
- Anthony C A Yii
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital , Singapore
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Asthma and wheezing are associated with depression and anxiety in adults: an analysis from 54 countries. Pulm Med 2013; 2013:929028. [PMID: 23577252 PMCID: PMC3613067 DOI: 10.1155/2013/929028] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 02/03/2013] [Indexed: 11/18/2022] Open
Abstract
Background. Asthma and depression are important public-health concerns worldwide. While some epidemiologic studies have shown asthma and wheezing to be associated with depression and anxiety, the patterns are unclear at the multinational level due to the lack of cross-study comparability. Our study examined the associations of self-reported asthma diagnosis and current wheezing with self-reported depression diagnosis and 30-day anxiety using an international survey. Methods. Using the 2002 World Health Survey, a standardized international survey conducted by the WHO, we estimated the associations between diagnosed asthma and current wheezing with diagnosed depression and 30-day anxiety via multiple logistic regressions for 54 countries worldwide. Results. Diagnosed depression and 30-day anxiety were associated with diagnosed asthma in 65% and 40% of the countries, respectively. Diagnosed depression and 30-day anxiety were associated with current wheezing in 83% and 82% of the countries, respectively. Conclusions. The association between asthma and depression was generally seen at the global level. These results indicated the importance of addressing the asthma-depression comorbidity as public-health and clinical management priorities, in order to improve the overall health of the countries.
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Liang W, Chikritzhs T. Asthma history predicts the risk of affective disorders and anxiety disorders. Health (London) 2013. [DOI: 10.4236/health.2013.52a042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Gonzalez-Barcala FJ, de la Fuente-Cid R, Tafalla M, Nuevo J, Caamaño-Isorna F. Factors associated with health-related quality of life in adults with asthma. A cross-sectional study. Multidiscip Respir Med 2012; 7:32. [PMID: 23031194 PMCID: PMC3489800 DOI: 10.1186/2049-6958-7-32] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 07/25/2012] [Indexed: 12/30/2022] Open
Abstract
Background The measurement of health-related quality of life (HRQoL) is increasingly recognized as an important endpoint, as a reflection of the effects of the disease from a patient perspective. Our aim was to evaluate the factors determining the HRQoL in patients with asthma, according to the EQ-5D questionnaire. Methods Patients were included using multi-stage sampling, from Primary Care clinics from all the Autonomous Communities in Spain. The patients included were: over 18 years-old, with a confirmed diagnosis of asthma for at least one year, and had visited a Health Centre in the previous 2 years. The characteristics of the asthma disease, the adherence to treatment, the socio-demographic variables, the smoking habits, and the asthma control were collected using a questionnaire. The influence of the different variables included in the study on the EQ-5D was evaluated using multivariate logistic regression analysis. Results A total of 2,125 patients were finally included (57.7% females, mean age 48 years). The response rate was 95.4%. Some factors showed a considerable detrimental effect on the HRQoL of asthmatics. Advanced age, lower educational level and poor control of asthma are significantly associated with a worse quality of life in all the dimensions assessed by the EQ-5D scale. The baseline severity of the asthma, and having been admitted to hospital are related to a worse quality of life in 5 of the 6 dimensions analyzed. Conclusion In our study, we could identify some factors related to quality of life in asthma patients. The most important were advanced age, lower education level, and poor control of the asthma.
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Shiratori Y, Samuelson KW. Relationship between posttraumatic stress disorder and asthma among New York area residents exposed to the World Trade Center disaster. J Psychosom Res 2012; 73:122-5. [PMID: 22789415 DOI: 10.1016/j.jpsychores.2012.05.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 05/10/2012] [Accepted: 05/10/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The heightened prevalence rates of respiratory problems and posttraumatic stress disorder (PTSD) among New York area residents following the World Trade Center disaster on September 11, 2001, have received national attention. Although there is some evidence suggesting that PTSD is associated with increased risk for asthma, this relationship has not been well documented in this population at high risk for both disorders. There is also a need to examine this relationship while controlling for notable confounds, including dust exposure and smoking. METHOD This study examined the association between symptoms indicative of probable PTSD and the diagnosis of asthma following 9/11 among the individuals who participated in the World Trade Center Health Registry (WTCHR) baseline study between September 2003 and November 2004. A total of 71,437 participants enrolled in this study and completed questionnaires pertaining to exposure, physical health symptoms before and after 9/11, and self-reported PTSD symptoms. RESULTS Logistic regression revealed that, compared to participants without probable PTSD, individuals with probable PTSD were 1.65 times more likely to be diagnosed with asthma following 9/11, which was significant after controlling for the effects of gender, ethnicity, income, smoking status, dust exposure, and nonspecific psychological distress [Wald χ(2) (1)=52.375, P<.001]. CONCLUSION These results suggest that PTSD symptoms are associated with the development of asthma following 9/11 and that this relationship is not explained by sociodemographic, environmental, and lifestyle factors.
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Affiliation(s)
- Yukie Shiratori
- California School of Professional Psychology, Alliant International University, San Francisco, USA
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Gershon AS, Guan J, Wang C, Victor JC, To T. Describing and quantifying asthma comorbidity [corrected]: a population study. PLoS One 2012; 7:e34967. [PMID: 22586445 PMCID: PMC3346768 DOI: 10.1371/journal.pone.0034967] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 03/09/2012] [Indexed: 12/31/2022] Open
Abstract
Background Asthma comorbidity has been correlated with poor asthma control, increased health services use, and decreased quality of life. Managing it improves these outcomes. Little is known about the amount of different types of comorbidity associated with asthma and how they vary by age. Methodology/Principal Findings The authors conducted a population study using health administrative data on all individuals living in Ontario, Canada (population 12 million). Types of asthma comorbidity were quantified by comparing physician health care claims between individuals with and without asthma in each of 14 major disease categories; results were adjusted for demographic factors and other comorbidity and stratified by age. Compared to those without asthma, individuals with asthma had higher rates of comorbidity in most major disease categories. Most notably, they had about fifty percent or more physician health care claims for respiratory disease (other than asthma) in all age groups; psychiatric disorders in individuals age four and under and age 18 to 44; perinatal disorders in individuals 17 years and under, and metabolic and immunity, and hematologic disorders in children four years and under. Conclusion/Significance Asthma appears to be associated with significant rates of various types of comorbidity that vary according to age. These results can be used to develop strategies to recognize and address asthma comorbidity to improve the overall health of individuals with asthma.
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Affiliation(s)
- Andrea S Gershon
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
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Liang W, Chikritzhs T, Lee AH. Lifestyle of young Australian adults with asthma. Asia Pac J Public Health 2012; 27:NP248-54. [PMID: 22426565 DOI: 10.1177/1010539512439229] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Asthma is a highly prevalent disease that may affect the lifestyle adopted by young adults. This study investigated whether asthma status influences fruit and vegetable consumption, physical activity level, tobacco smoking, and alcohol drinking behavior of young adults in Australia. Information of 2619 participants aged 18 to 29 years was extracted from the 2007-2008 Australian National Health Survey database. The level of physical activity and fruit consumption were found to be similar between young adults with and without asthma. Participants with asthma symptoms in the past 12 months were more likely to achieve the dietary recommendation for vegetable intake, but they tended to smoke tobacco and consume alcohol above safe levels. It may be necessary to develop prevention strategies targeting young adults with asthma that include screening for harmful use of substances.
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Affiliation(s)
- Wenbin Liang
- Curtin University, Perth, Western Australia, Australia
| | | | - Andy H Lee
- Curtin University, Perth, Western Australia, Australia
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Dillard DA, Smith JJ, Ferucci ED, Lanier AP. Depression prevalence and associated factors among Alaska Native people: the Alaska education and research toward health (EARTH) study. J Affect Disord 2012; 136:1088-97. [PMID: 22138285 PMCID: PMC3289282 DOI: 10.1016/j.jad.2011.10.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 10/26/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND Few studies have investigated depression among Alaska Native people (ANs). Depression prevalence and associated factors among EARTH Alaska study participants are described. METHODS The nine-item Patient Health Questionnaire (PHQ-9) assessed depression among 3771 ANs. Participants with PHQ-9 scores≥10 out of 27 were classified as positive for depression. Logistic regression analyses evaluated odds of scoring positive versus negative for depression by demographic, cultural, then health and lifestyle factors. RESULTS Twenty percent of women and 13% of men scored positive for depression. Univariate and multivariate models were fit separately for men and women. Among demographic factors, below median income was associated with positive depression scores for both genders. Among men, odds of depression were higher if unmarried and/or if highest educational level was less than high school. Women 34 to 59 years of age had increased odds of scoring positive. Little or no identification with tribal tradition was associated with increased odds of depression in women and decreased odds in men. For both genders, chronic physical conditions and poorer self-reported health were associated with positive depression scores then binge alcohol drinking and current tobacco use increased odds of depression among women only. LIMITATIONS Factors analyzed were self-reported without clinician follow-up in a non-random convenience sample of adults. CONCLUSIONS Depression is common among ANs with rates comparable to other indigenous cross-sectional investigations. Depression is associated with lower income and poorer physical health. Prevention and intervention efforts should consider gender as other associated factors varied between men and women.
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Affiliation(s)
- Denise A. Dillard
- Research Department, Southcentral Foundation, 4501 Diplomacy Drive, Suite 200, Anchorage, AK, 99508, USA
,(907) 729-8518, (907) 729-5464 fax,
| | - Julia J. Smith
- Research Department, Southcentral Foundation, 4501 Diplomacy Drive, Suite 200, Anchorage, AK, 99508, USA
| | | | - Anne P. Lanier
- Alaska Native Tribal Health Consortium, Anchorage, AK, USA
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Wang G, Zhou T, Wang L, Wang L, Fu JJ, Zhang HP, Ji YL. Relationship between current psychological symptoms and future risk of asthma outcomes: a 12-month prospective cohort study. J Asthma 2012; 48:1041-50. [PMID: 22091741 DOI: 10.3109/02770903.2011.631238] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Subjects with asthma are more susceptible to psychological symptoms, but it is uncertain whether psychological symptoms are linked to future risk of asthma outcomes. OBJECTIVE To investigate the relationship between current psychological symptoms and future risk of asthma outcomes. METHODS We conducted a prospective cohort study with a 12-month follow-up period of 297 patients with asthma. Psychological symptoms, lung function, asthma control test, and Asthma Quality of Life Questionnaire at baseline were assessed. Asthma outcomes including exacerbations, unplanned visits, emergency visits, hospital admissions, intensive care unit admissions, and length of hospital stays were monitored monthly. The time to the first asthma outcomes was analyzed. Furthermore, the association between psychological symptoms and future risk of asthma outcomes was calculated as adjusted relative risk (RR) using logistic regression models. RESULTS The asthma patients were assigned to one of three groups: neither anxiety nor depression symptoms (NAD, n = 102), either anxiety or depression symptoms (A/D, n = 68), or anxiety and depression symptoms (AD, n = 120). Logistic regression models indicated that asthma patients in the AD group, but not the A/D group, had an increased adjusted RR for unplanned visits and emergency visits (RR = 2.33, 95% confidence interval (CI) = [1.50, 3.61]; and RR = 3.13, 95% CI = [1.90, 5.17], respectively). The time to the first asthma outcomes including exacerbations, unplanned visits, and emergency visits was shorter in patients with psychological symptoms than those without (all p < .001). CONCLUSION Current psychological symptoms, especially anxiety combined with depression, independently predict the future risk of asthma outcomes. Ting Zhou and Lan Wang contributed equally to this study.
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Affiliation(s)
- Gang Wang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, PR China
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Spitzer C, Gläser S, Grabe HJ, Ewert R, Barnow S, Felix SB, Freyberger HJ, Völzke H, Koch B, Schäper C. Mental health problems, obstructive lung disease and lung function: findings from the general population. J Psychosom Res 2011; 71:174-9. [PMID: 21843753 DOI: 10.1016/j.jpsychores.2011.03.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Revised: 03/02/2011] [Accepted: 03/15/2011] [Indexed: 11/29/2022]
Abstract
OBJECTIVE There is cumulative evidence for a strong association of obstructive lung disease, i.e. asthma and COPD, with poor mental health, particularly with anxiety disorders and major depression. However, studies relating mental health problems to objective measures of lung function as assessed by spirometry are lacking. METHODS The 12-month prevalence of specific psychopathological syndromes among 1772 adults from the general population was estimated by a structured interview. Additionally, participants underwent spirometry and were asked about obstructive lung disease in the year prior to the study. Logistic and linear regression models were used to relate obstructive lung disease and spirometrically defined airway obstruction to mental health problems. RESULTS Mental health problems were found in 35.7% of the participants. After adjusted for sociodemographic, clinical and life-style factors, asthma and chronic bronchitis were associated with almost all domains of mental health problems. In contrast, independent of its definition, spirometric airflow limitation was only related to generalized anxiety (odds ratios ranging from 2.3 to 2.7). A reduced ratio of forced expiratory volume in one second to forced vital capacity was associated with mental health problems in general and panic and general anxiety in particular. CONCLUSION Our findings suggest an association of objective measure of airflow limitation to generalized anxiety and panic. While the causal relationship between obstructive lung disease, airflow limitation and anxiety remains to be determined, clinicians should pay diagnostic attention to the significant overlap of these conditions.
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Affiliation(s)
- Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Schön Klinik Hamburg-Eilbek, Hamburg, Germany.
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Common behavioral problems among children with asthma: is there a role of asthma treatment? Ann Allergy Asthma Immunol 2011; 106:200-4. [PMID: 21354021 DOI: 10.1016/j.anai.2010.11.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Revised: 11/10/2010] [Accepted: 11/21/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND An increased prevalence of behavioral problems has been described among children with asthma. OBJECTIVE To investigate those associations between common behavioral problems and asthma, with an emphasis on the roles of medications used for asthma. METHOD We studied 409 children who had been followed-up in pediatric allergy clinics and 157 age-matched healthy controls. A diagnostic and statistical manual disorder-referenced symptom inventory was used to assess "attention deficit-hyperactivity disorder" (ADHD), "attention deficit" (AD), "hyperactivity and impulsivity" (HI), and "oppositional defiant disorder" (ODD) behavioral problems. RESULTS The study group consisted of 409 patients (male: 251, female: 158), with a mean age of 9.0 ± 2.67 years, and the control group consisted of 157 children (male: 75, female: 82), with a mean age of 9.0 ± 2.86 years. Prevalences of AD, hyperactivity, ADHD, and ODD were not significantly different between the study and control groups. Among those patients receiving leukotriene antagonist (LA) drugs adjunctive to inhaled corticosteroids (ICS), duration of treatment was correlated with total scores calculated for hyperactivity (P = .035, r = 0.432), AD (P = .044, r = 0.414), ADHD (P = .042, r = 0.418), and ODD (P = .032, r = 0.439). Among patients with asthma, children with ODD had a significantly longer duration of LA+ICS use (P = .024) compared with those with no ODD. Patients with hyperactivity had a longer duration of ICS+LA use compared with those with no hyperactivity (P = .009). Patients with asthma receiving LA+ICS treatment had a higher risk for oppositional behavior (4.282 times compared with the control group [P = .042, confidence interval (CI): 1.542-15.949]) and 8.3 times compared with patients with asthma not using any drug (P = .021, CI: 1.419-48.543). CONCLUSION Rather than asthma itself, adjunctive use of ICS+LA therapy appears to be related with symptoms of common behavioral problems, including hyperactivity, AD, ADHD, and ODD and to increase the risk of ODD.
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Trogdon JG, Nurmagambetov TA, Thompson HF. The economic implications of influenza vaccination for adults with asthma. Am J Prev Med 2010; 39:403-10. [PMID: 20965377 DOI: 10.1016/j.amepre.2010.07.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Revised: 03/19/2010] [Accepted: 07/15/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND Influenza vaccination is recommended for adults with asthma. PURPOSE This study estimates the effect of influenza vaccination on utilization of medical services and expenditures for acute and chronic respiratory conditions (ACRC) among adults with asthma. METHODS The sample was adults aged ≥18 years self-reporting asthma in the 2003 through 2006 Medical Expenditure Panel Survey (MEPS), covering four complete influenza seasons. The dependent variables were indicators for any ACRC claims within service category and ACRC expenditures. The main independent variable was an indicator of influenza vaccination. To control for selection bias in the observational data, a nonlinear instrumental variables approach was used. The instruments were indicators for influenza in the first year of MEPS and vaccination in the year prior to MEPS. Data were analyzed in 2009. RESULTS Adults with asthma vaccinated for influenza were 4.4 percentage points less likely to have an inpatient stay due to ACRC (95% CI = -10.8, -1.0). Influenza vaccination was associated with a $492 decrease (95% CI = -$1591, -$56) in annual ACRC nonprescription expenditures, a $224 increase (95% CI = $70, $360) in annual ACRC prescription expenditures, and a nonsignificant $216 decrease (95% CI = -$854, $248) in overall annual ACRC expenditures. CONCLUSIONS Although there was no evidence that vaccination reduced overall ACRC expenditures, the study suggests that efforts to increase the percentage of adults with asthma who are vaccinated may bring substantial benefits in terms of reducing the prevalence and costs of hospitalization although raising prescription medication costs, possibly through improvement in compliance.
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Affiliation(s)
- Justin G Trogdon
- Public Health Economics Program, RTI International, Research Triangle Park, North Carolina, USA.
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Wang G, Wang L, Szczepaniak WS, Xiong ZY, Wang L, Zhou T, Fu JJ, Liang BM, Yuan YR, Li T, Ji YL. Psychological status in uncontrolled asthma is not related to airway hyperresponsiveness. J Asthma 2010; 47:93-9. [PMID: 20100027 DOI: 10.3109/02770900903331119] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Airway hyperresponsiveness (AHR) is the characteristic functional abnormality of asthma, and previous studies have shown the potential for AHR to be influenced by psychological factors, yet the relationship between anxiety and/or depression and AHR remains unclear in patients with asthma. OBJECTIVE To explore the relationship between psychological status and AHR in asthma patients. METHODS In a cross-sectional study, 168 adult subjects were recruited with physician-diagnosed uncontrolled asthma and a positive result for AHR in methacholine (Mch) challenge test. Psychological status, asthma control, and asthma quality of life were assessed using Zung self-rating anxiety/depression scale, asthma control test (ACT), and asthma quality of life questionnaire (AQLQ), respectively. AHR severity was evaluated and quantified by the provocative concentration of Mch, which evoked a given decrease of 20% in FEV(1). RESULTS A total of 70.23% of recruited patients (n = 118) met the diagnostic criteria for anxiety and/or depression. There was a trend between negative psychological status and AHR in asthma patients that did not reach statistical significance, but no independent effects of negative mood states (anxiety, depression, or both) on AHR were established. Further, analyses revealed that only anxiety is associated with worse asthma control (p = 0.029), and a significant interaction effect of depression and anxiety accounted for lower asthma-related quality-of-life scores (p < 0.001). CONCLUSIONS AHR and psychological status are loosely related to each other even if in uncontrolled asthma.
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Affiliation(s)
- Gang Wang
- Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
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Kim WJ, Bae H, Choi BK, Hwang JM, Shin KH, Kim MH, Lee K, Kim KU, Jeon DS, Park HK, Kim YS, Lee MK, Park SK. Depressive Conditions in Relation to Asthma Severity and Control. Tuberc Respir Dis (Seoul) 2010. [DOI: 10.4046/trd.2010.69.4.265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Won Jin Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Hyunsook Bae
- Department of Preventive and Occupational Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Bo Kyung Choi
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jong Min Hwang
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kyung Hwa Shin
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Mi Hyun Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kwangha Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Ki Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Doo Soo Jeon
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Hye-Kyung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Yun Seong Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Soon Kew Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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Pahwa P, Karunanayake CP. Modeling of longitudinal polytomous outcome from complex survey data--application to investigate an association between mental distress and non-malignant respiratory diseases. BMC Med Res Methodol 2009; 9:84. [PMID: 20017948 PMCID: PMC2806372 DOI: 10.1186/1471-2288-9-84] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Accepted: 12/17/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The data from longitudinal complex surveys based on multi-stage sampling designs contain cross-sectional dependencies among units due to clustered nature of the data and within-subject dependencies due to repeated measurements. Special statistical methods are required to analyze longitudinal complex survey data. METHODS Statistics Canada's longitudinal National Population Health Survey (NPHS) dataset from the first five cycles (1994/1995 to 2002/2003) was used to investigate the effects of demographic, social, life-style, and health-related factors on the longitudinal changes of mental distress scores among the NPHS participants who self-reported physician diagnosed respiratory diseases, specifically asthma and chronic bronchitis. The NPHS longitudinal sample includes 17,276 persons of all ages. In this report, participants 15 years and older (n = 14,713) were considered for statistical analysis. Mental distress, an ordinal outcome variable (categories: no/low, moderate, and high) was examined. Ordered logistic regression models based on the weighted generalized estimating equations approach were fitted to investigate the association between respiratory diseases and mental distress adjusting for other covariates of interest. Variance estimates of regression coefficients were computed by using bootstrap methods. The final model was used to predict the probabilities of prevalence of no/low, moderate or high mental distress scores. RESULTS Accounting for design effects does not vary the significance of the coefficients of the model. Participants suffering with chronic bronchitis were significantly at a higher risk (ORadj = 1.37; 95% CI: 1.12-1.66) of reporting high levels of mental distress compared to those who did not self-report chronic bronchitis. There was no significant association between asthma and mental distress. There was a significant interaction between sex and self-perceived general health status indicating a dose-response relationship. Among females, the risk of mental distress increases with increasing deteriorating (from excellent to very poor) self-perceived general health. CONCLUSIONS A positive association was observed between the physician diagnosed self-reported chronic bronchitis and an increased prevalence of mental distress when adjusted for important covariates. Variance estimates of regression coefficients obtained from the sandwich estimator (i.e. not accounting for design effects) were similar to bootstrap variance estimates (i.e. accounting for design effects). Even though these two sets of variance estimates are similar, it is more appropriate to use bootstrap variance estimates.
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Affiliation(s)
- Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N OW8, Canada
- Department of Community Health and Epidemiology, University of Saskatchewan, 103 Hospital drive, Saskatoon, SK, S7N OW8, Canada
| | - Chandima P Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N OW8, Canada
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Philip G, Hustad CM, Malice MP, Noonan G, Ezekowitz A, Reiss TF, Knorr B. Analysis of behavior-related adverse experiences in clinical trials of montelukast. J Allergy Clin Immunol 2009; 124:699-706.e8. [PMID: 19815116 DOI: 10.1016/j.jaci.2009.08.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Revised: 08/11/2009] [Accepted: 08/12/2009] [Indexed: 11/17/2022]
Abstract
BACKGROUND Frequencies of behavior-related adverse experiences (BRAEs) in controlled clinical studies of leukotriene modifier drugs have not been summarized. OBJECTIVE We sought to compare the frequency of BRAEs in patients receiving montelukast or placebo in a retrospective analysis of Merck clinical trial data. METHODS An adverse experience database was constructed to include all double-blind, placebo-controlled trials of montelukast meeting prespecified criteria. BRAEs (described using the Medical Dictionary for Regulatory Activities controlled vocabulary dictionary) were prespecified to include any term in the Psychiatric Disorders System Organ Class, selected terms related to general disorders, and terms related to akathisia. Frequencies of BRAEs (overall, leading to study discontinuation, and/or serious) were summarized. Analyses estimated the odds ratios (ORs) for montelukast versus placebo based on the frequency of patients with BRAEs in each study. RESULTS In total 35 adult and 11 pediatric placebo-controlled trials were included; 11,673 patients received montelukast, 8,827 received placebo, and 4,724 received active control. The frequency of patients with 1 or more BRAEs was 2.73% and 2.27% in the montelukast and placebo groups, respectively; the OR for montelukast versus placebo was 1.12 (95% CI, 0.93-1.36). The frequency of patients with a BRAE leading to study discontinuation was 0.07% and 0.11% in the montelukast and placebo groups, respectively (OR, 0.52; 95% CI, 0.17-1.51). The frequency of patients with a BRAE considered serious was 0.03% in both treatment groups. CONCLUSION Reports of BRAEs were infrequent in clinical trials of montelukast. Those leading to study discontinuation or considered serious were rare. Frequencies were similar regardless of treatment group.
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Oraka E, King ME, Callahan DB. Asthma and serious psychological distress: prevalence and risk factors among US adults, 2001-2007. Chest 2009; 137:609-16. [PMID: 19837824 DOI: 10.1378/chest.09-1777] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND For millions of adults, effective control of asthma requires a regimen of care that may be compromised by psychological factors, such as anxiety and depression. This study estimated the prevalence and risk factors for serious psychological distress (SPD) and explored their relationship to health-related quality of life (HRQOL) among adults with asthma in the United States. METHODS We analyzed data from 186,738 adult respondents from the 2001-2007 US National Health Interview Survey. We calculated weighted average prevalence estimates of current asthma and SPD by demographic characteristics and health-related factors. We used logistic regression analysis to calculate odds ratios for factors that may have predicted asthma, SPD, and HRQOL. RESULTS From 2001 to 2007, the average annual prevalence of current asthma was 7.0% and the average prevalence of SPD was 3.0%. Among adults with asthma, the prevalence of SPD was 7.5% (95% CI, 7.0%-8.1%). A negative association between HRQOL and SPD was found for all adults, independent of asthma status. A similar pattern of risk factors predicted SPD and the co-occurrence of SPD and asthma, although adults with asthma who reported lower socioeconomic status, a history of smoking or alcohol use, and more comorbid chronic conditions had significantly higher odds of SPD. CONCLUSION This research suggests the importance of mental health screening for persons with asthma and the need for clinical and community-based interventions to target modifiable lifestyle factors that contribute to psychological distress and make asthma worse.
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Affiliation(s)
- Emeka Oraka
- Centers for Disease Control and Prevention, National Center for Environmental Health, Air Pollution and Respiratory Health Branch, Atlanta, GA, USA.
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Abstract
Chronic lung diseases continue to be common and cause significant morbidity and mortality. There is a complex interplay between psychiatric issues and pulmonary diseases. This review aims to summarize the recent literature and advances involving psychiatric aspects of lung diseases, including chronic obstructive pulmonary disease, asthma, restrictive lung disease, and cystic fibrosis. The authors include the latest findings in epidemiology, impact, etiology, screening, and management of psychiatric and pulmonary comorbidity. The relationship between mental health and lung disease, as it is between mental health and other physical illnesses, is multifactorial. Further studies continue to clarify issues and treatment guidelines for this comorbidity.
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Affiliation(s)
- Abhishek Jain
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
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Mannino DM. Doc, my asthma (depression) has gotten me down (wheezing). Chest 2009; 134:1116-1117. [PMID: 19059954 DOI: 10.1378/chest.08-2047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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