Associations of symptoms of anxiety and depression with health-status, asthma control, dyspnoea, dysfunction breathing and obesity in people with severe asthma

• Published in: Respiratory research Vol. 23; no. 1; p. 341
• Main Authors: Stubbs, Michelle A, Clark, Vanessa L, Gibson, Peter G, Yorke, Janelle, McDonald, Vanessa M
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12-12-2022; BioMed Central; BMC
• Subjects: Adult; Aged; Ambulatory care; Antidepressants; Anxiety; Anxiety - diagnosis; Anxiety - epidemiology; Anxiety disorders; Asthma; Asthma - complications; Asthma - diagnosis; Asthma - epidemiology; Asthma control; Care and treatment; Comorbidity; Complications and side effects; Demographics; Depression; Depression - diagnosis; Depression - epidemiology; Depression, Mental; Development and progression; Diagnosis; Dyspnea; Dyspnea - diagnosis; Dyspnea - epidemiology; Dyspnoea; Female; Health aspects; Hospitals; Humans; Male; Medical research; Mental depression; Middle Aged; Multidimensional methods; Multivariate analysis; Neutrophils; Obesity; Obesity - complications; Obesity - diagnosis; Obesity - epidemiology; Population; Psychological aspects; Quality of Life; Questionnaires; Regression analysis; Respiration; Severe asthma; Statistical analysis; Steroids; Subgroups; United Kingdom; England; United Kingdom > UK; Australia; New South Wales Australia; Obesity; Dysfunctional breathing; Dyspnoea; Asthma control; Depression; Anxiety; Severe asthma; Quality of life
• ISSN: 1465-993X; 1465-9921; 1465-993X; 1465-9921
• DOI: 10.1186/s12931-022-02266-5

Anxiety and depression are comorbidities of severe asthma. However, clinical characteristics associated with coexisting severe asthma and anxiety/depression are poorly understood. The study objective is to determine clinical characteristics associated with anxiety and depressive symptoms in severe asthma.
Severe asthma participants (N = 140) underwent a multidimensional assessment. Categorization of symptoms of anxiety and depression were based on HADS scale sub-scores and divided into four groups (< 8 on both subscales; ≥ 8 on one subscale; ≥ 8 on both subscales). Clinical characteristics were compared between subgroups. Multivariate logistic regression determined associations of clinical characteristics and anxiety and/or depressive symptoms in people with severe asthma.
Participants were (mean ± SD) 59.3 ± 14.7 years old, and 62% female. There were 74 (53%) severe asthma participants without symptoms of anxiety/depression, 11 (7%) with symptoms of anxiety, 37 (26%) with symptoms of depression and 18 (13%) with symptoms of anxiety and depression. Quality of life impairment was greater in participants with symptoms of depression (4.4 ± 1.2) and combined symptoms of anxiety and depression (4.4 ± 1.1). Asthma control was worse in those with symptoms of depression (2.9 ± 1.1) and combined anxiety and depression (2.6 ± 1.0). In multivariate models, dysfunctional breathing was associated with symptoms of anxiety (OR = 1.24 [1.01, 1.53]). Dyspnoea was associated with symptoms of depression (OR = 1.90 [1.10, 3.25]). Dysfunctional breathing (OR 1.16 [1.04, 1.23]) and obesity (OR 1.17 [1.00, 1.35]) were associated with combined symptoms of anxiety and depression.
People with severe asthma and anxiety and/or depressive symptoms have poorer QoL and asthma control. Dyspnoea, dysfunctional breathing and obesity are associated with these symptoms. These key clinical characteristics should be targeted in severe asthma management.