Effects of depressive symptoms on health-related quality of life in asthma patients

Abstract

OBJECTIVE:To assess the effects of depressive symptoms on asthma patients' reports of functional status and healthrelated quality of life. DESIGN:Cross-sectional study.SETTING: Primary care internal medicine practice at a tertiary care center in New York City. PATIENTS:We studied 230 outpatients between the ages of 18 and 62 years with moderate asthma. Stepwise multivariate analyses were conducted with the AQLQ and SF-36 scores as the dependent variables and depressive symptoms, comorbidity, asthma, and demographic characteristics as independent variables. The mean age of patients was 41 ؎ SD 11 years and 83% were women. The mean GDS score was 11 ؎ SD 8 (possible range, 0 to 30; higher scores reflect more depressive symptoms), and a large percentage of patients, 45%, scored above the threshold considered positive for depression screening. Compared with patients with a negative screen for depressive symptoms, patients with a positive screen had worse composite AQLQ scores (3.9 ؎ SD 1.3 vs 2.8 ؎ SD 0.8, P Ͻ .0001) and worse PCS scores (40 ؎ SD 11 vs 34 ؎ SD 8, P Ͻ .0001) and worse MCS scores (48 ؎ SD 11 vs 32 ؎ SD 10, P Ͻ .0001) scores. In stepwise analyses, current asthma activity and GDS scores had the greatest effects on patient-reported health-related quality of life, accounting for 36% and 11% of the variance, respectively, for the composite AQLQ, and 11% and 38% of the variance, respectively, for the MCS in multivariate analyses. MEASUREMENTS AND MAIN RESULTS: CONCLUSIONS:Nearly half of asthma patients in this study had a positive screen for depressive symptoms. Asthma patients with more depressive symptoms reported worse healthrelated quality of life than asthma patients with similar disease activity but fewer depressive symptoms. Given the new emphasis on functional status and health-related quality of life measured by disease-specific and general health scales, we conclude that psychological status indicators should also be considered when patient-derived measures are used to assess outcomes in asthma. KEY WORDS

Psychological distress and associated risk factors in bronchial asthma patients in Kuwait

“…Adams et al [14] documented that psychological distress and decreased feelings are common in asthmatics. In another study by Manucoso, nearly 50% of asthma patients were found to suffer from clinically signifi cant depressive symptoms, [15] and it was attributed to the stress of having a chronic illness. [16] In clinical samples of children and adolescents, asthma has been associated with presence of an anxiety disorder [17] and depressive symptoms among youth with moderate-to-severe persistent asthma.…”

Health Related Quality of Life in Coronary Patients

“…In the same way, Höfer et al (Höfer et al, 2006) also observed a significant positive change over time for the physical component summary dimension (PCS) of the SF-36, but not for the mental component summary dimension (MCS). However, other authors (Elliott et al, 2003;Mancuso et al, 2000;Wells et al, 1989) have shown that the SF-36 MCS is a good indicator of depression in general and diseased populations and Tavella et al (Tavella et al, 2010) have even established a threshold score on the SF-36 MCS that would categorise a population with cardiac disease into depressed and non-depressed patients.…”

The COPD Helplessness Index

“…[23][24][25] Depressive symptoms were obtained using the 15-item short-form Geriatric Depression Scale, which has been validated in nongeriatric populations generally, as well as specifi cally in younger adults with obstructive lung disease. [26][27][28] Anxiety was assessed using the seven-item anxiety subscale of the Hospital Anxiety and Depression Scale. 29,30 COPD severity was assessed with the Body-Mass, Obstruction, Dyspnea, Exercise (BODE) Index, a multidimensional score which includes FEV 1 , 6-min walk test, BMI, and dyspnea.…”