Asthma Severity, Psychiatric Morbidity, and Quality of Life: Correlation with Inhaled Corticosteroid Dose

Asthma Severity, Psychiatric Morbidity, and Quality of Life: Correlation with Inhaled Corticosteroid Dose

Objectives. Psychiatric phenomena in asthma has been debated for some time. Inhaled corticosteroids (ICS) are a significant part of treatment. We attempted to quantify the prevalence of psychiatric morbidity relative to asthma severity, quality of life (QOL), and ICS dose. Data Sources. Fifty asthma...

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Bibliographic Details
Published in:The Journal of asthma Vol. 40; no. 6; pp. 691 - 699
Main Authors: Bonala, Savithri B., Pina, Desiderio, Silverman, Bernard A., Amara, Sreenivasrao, Bassett, Clifford W., Schneider, Arlene T.
Format: Journal Article
Language:English
Published: New York, NY Informa UK Ltd 01-01-2003
Taylor & Francis
Informa Healthcare
Subjects:
Administration, Inhalation
Adrenal Cortex Hormones - administration & dosage
Adult
Affect
Anti-Inflammatory Agents - administration & dosage
Asthma
Asthma - drug therapy
Asthma - ethnology
Asthma - psychology
Biological and medical sciences
Chronic obstructive pulmonary disease, asthma
Female
Humans
Inhaled corticosteroids
Male
Medical sciences
Middle Aged
Morbidity
Pneumology
Prevalence
Psychiatric morbidity
Quality of Life
Severity of Illness Index
Surveys and Questionnaires
Human
Corticosteroid
Prognosis
Prevalence
Respiratory disease
Treatment efficiency
Antiinflammatory agent
Inhaled corticosteroids
Antiasthma agent
Asthma
Inhalation
Quality of life
Concomitant disease
Chemotherapy
Psychiatric morbidity
Treatment
Severity score
Obstructive pulmonary disease
Psychopathology
Dose
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Summary:Objectives. Psychiatric phenomena in asthma has been debated for some time. Inhaled corticosteroids (ICS) are a significant part of treatment. We attempted to quantify the prevalence of psychiatric morbidity relative to asthma severity, quality of life (QOL), and ICS dose. Data Sources. Fifty asthmatic patients (18 ≥ X ≤ 75 years) on ICS, attending an urban clinic had asthma and ICS dose stratified by symptom severity and preparation potency. Peak flow and forced expiratory volume in 1 second (FEV1) were measured. Patients completed general QOL and disease-specific QOL questionnaires, along with psychiatric rating scales. Results. Patients (n = 50) clustered in the 40-59 year range (n = 27, 54%) and were predominantly female (n = 44, 88%) Hispanics (n = 30, 60%), with mild-moderate asthma (n = 18, 36%) and on low-dose ICS (n = 22, 44%). FEV1 ranged from 32 to 123 (mean 76.98, SE 3.01). Peak flow ranged from 210 to 590 (mean 407.83, SE 13.24). Prevalence of anxiety and depressive symptoms were higher than expected (Kendall's tau-c, n = 50, P < .01). Independently, high ICS dose and asthma severity correlated directly with all measures of psychiatric morbidity (Pearson's r 0.781, P < .01). High ICS dose correlated inversely with SF-36 Mental Component Scale (Pearson's r 0.681, P < .01) and directly with FEV1 and peak flow when age sex adjusted (Spearman's rho: 0.660, P < .001). Conclusions. Psychiatric morbidity is more prevalent in this population and impacts negatively on QOL. Use of high-dose ICS benefited pulmonary function and "physical" QOL, yet may have negatively affected patients' mental well-being. Longitudinal follow-up, extension of sample size, and better study control would allow closer approximation of possible negative associations with ICS.
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SourceType-Scholarly Journals-1
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ISSN:0277-0903
1532-4303
DOI:10.1081/JAS-120023491