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

Effect of psychological and other factors on quality of life amongst asthma outpatients in Lagos, Nigeria

BACKGROUND

This study aimed to assess the effect of psychological and other possible factors associated with poor health related quality of life (HRQOL) in outpatient with asthma in Lagos, Nigeria.

METHODS

Patients (n  = 201) recruited from the adult asthma outpatient clinic were assessed for sociodemographic and asthma related variables. Levels of social support (with Oslo 3-Item Social Support Scale), disability (with WHO Disability Assessment Scale) were assessed. The presence of anxiety and depression was assessed using the Mini International Neuropsychiatric Interview (M.I.N.I) and asthma related quality of life was assessed with the Mini-Asthma Quality of Life Questionnaire (Mini-AQLQ).

RESULTS

Of the 4 domains of Mini-AQLQ, the "environmental" domain has the lowest weighted mean score of 2.43 (SD = 1.64) while the "activity limitation" domain has the highest mean score of 4.74 (SD = 1.57). Poor asthma related QOL was independently associated with being unemployed (p = 0.028), poor social support (p = 0.002), nocturnal asthma (p = 0.046), clinically rated "severe asthma" (p = 0.002), patients rated "severe asthma" (p < 0.001), high level of disability (p < 0.001) and presence of Anxiety/Depression (p < 0.001).

CONCLUSION

Our study has shown that psychological variables, disability, patients' subjective severity rating and social support are the most important factors independently associated with asthma related QOL. These factors should be considered in planning health care services or formulating a predictive intervention model.

Anxiety and depression among Nigerian patients with asthma; Association with sociodemographic, clinical, and personality factors

OBJECTIVE

To estimate the rate of anxiety and depression in adult asthma patients and examine the possible association with sociodemographic, clinical and other significant variables.

METHODS

Adult asthmatics (n = 203) were recruited from the asthma outpatient clinic and assessed for sociodemographic and clinical profiles, their levels of disability, social support, asthma treatment stigma and personality traits. The Mini International Neuropsychiatric Interview (M.I.N.I) was used to assess for the diagnosis of Anxiety and Depression in comparison with matched healthy controls (n = 205).

RESULTS

Seventy (34.5%) of the patients with asthma have a diagnosis of Anxiety or Depression compared with 15 (7.3%) of matched healthy controls and the difference was significant (OR 6.67, 95% CI 3.58-13.04). Although older age, lower income, use of oral corticosteroid, patients perceived severity of asthma, disability, social support and personality traits were initially significant in univariate analysis, a subsequent logistic regression analysis revealed that only disability scores above the group mean (OR 4.50, 95% CI 2.28-8.87) and not having a strong social support (OR 2.88, 95% CI 1.443-5.78) were the only variables independently associated with diagnosis of Anxiety and Depression in the group of patients with asthma.

CONCLUSION

Anxiety and depression are significantly more common in adult outpatients with asthma when compared with healthy control in Nigeria and was significantly associated with levels of disability and social support. These factors should be considered while formulating predictive models for management of psychosocial problems in asthma in this environment.

Health related quality of life and psychological variables among a sample of asthmatics in Ile-Ife South-Western Nigeria

BACKGROUND

Assessment of health related quality of life (HRQL) has become central to assessing the self-perceived impact of physical and mental impairment on patient's health. Studies have reported a high rate of psychological disturbances among asthmatics; however, the impact of these psychological factors on HRQL remains unexplored.

OBJECTIVES

To assess the health related quality of life among a sample of asthmatics and to identify the psychological and clinical variables that affect quality of life among asthmatics.

METHOD

A total of 81 patients attending the clinic were assessed using the Mini-Asthma Quality of Life questionnaire (Mini-AQLQ), and the Hospital Anxiety and Depression Scale (HADS). Sociodemographic and clinical variables were also obtained from the patients, the lung function was assessed using Peak Expiratory Flow Rate (PEFR).

RESULTS

Mean age of all the patients was 35.22 (SD±14.36) with a mean duration of asthma symptoms of 17.5 (SD±14.4) years. Mean peak expiratory flow was 336 l/min (SD±74.12). Anxiety was present in 44.4% of respondents, while 40% of respondents reported the presence of depressive symptoms, 48.1% of the respondents reported low scores on the asthma quality of life questionnaire. Poor quality of life was associated with the presence of psychological symptoms, female sex, and lower educational level.

CONCLUSION

Psychosocial variables are just as important as clinical variables as determinants of health related quality of life among asthmatics.