The impact of anxiety and depression on outpatients with asthma

Ciprandi, Giorgio; Schiavetti, Irene; Rindone, E; Ricciardolo, Fabio Luigi Massimo

doi:10.1016/j.anai.2015.08.007

Cited by 154 publications

(93 citation statements)

References 45 publications

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“…We also found that psychological disturbance was important in the Chinese population. We identified 15.4% (n=57) of patients with psychological symptoms, which is similar to other studies (16,17). There was a higher prevalence of psychological symptoms in patients with uncontrolled or severe asthma, which is also similar to other studies (18).…”

Section: Discussionsupporting

confidence: 79%

Severe and uncontrolled asthma in China: a cross-sectional survey from the Australasian Severe Asthma Network

Wang¹,

Wang²,

Gibson³

et al. 2017

J. Thorac. Dis.

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Background: Severe asthma is largely unexplored in the Chinese population. Patients with asthma underwent systematic evaluation, by investigating the characteristics of uncontrolled asthma and of asthma treated with three different controller therapies. Methods: This multi-centre, real-world study was conducted from March 2014 to September 2015. Adults with stable asthma underwent assessment of medication use, asthma control, quality of life, psychological symptoms, work productivity and activity impairment, bronchodilator response and sputum induction. Results: Participants (n=379) had a mean (SD) age of 47.4 (14.0) years, and 57.0% were female. There were 14.8% (n=56) of patients receiving treatment with Step 4/5 as severe asthma, but only 13 (3.4%) met ERS/ATS severe refractory asthma criteria. The patients with severe asthma usually used triple controller therapy: ICS/LABA, additional leukotriene modifier or theophylline, and reported better asthma control.Two fifths of patients (n=147) had uncontrolled asthma, with worse symptoms, psychological symptoms (both Conclusions: Although there is a relatively low proportion of severe refractory asthma based on ERS/ATS criteria, two of five patients with asthma in China are uncontrolled, displaying more psychological symptoms and reduced work productivity. Substantial gain in asthma control is obtained by triple controller therapy and this may be a promising therapeutic option for persistent asthma.

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Section: Discussionsupporting

confidence: 79%

Severe and uncontrolled asthma in China: a cross-sectional survey from the Australasian Severe Asthma Network

Wang¹,

Wang²,

Gibson³

et al. 2017

J. Thorac. Dis.

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show abstract

“…Up to 18% of asthma patients have depression, while 11%‐37% have anxiety . Patients with difficult asthma have even higher rates of depression and anxiety, at 31% and 81% for depression and anxiety respectively in one study …”

Section: How Common Are Comorbidities In Difficult Asthma?mentioning

confidence: 92%

Comorbid “treatable traits” in difficult asthma: Current evidence and clinical evaluation

Tay

Hew

2017

Allergy

130

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The care of patients with difficult-to-control asthma ("difficult asthma") is challenging and costly. Despite high-intensity asthma treatment, these patients experience poor asthma control and face the greatest risk of asthma morbidity and mortality.Poor asthma control is often driven by severe asthma biology, which has appropriately been the focus of intense research and phenotype-driven therapies. However, it is increasingly apparent that extra-pulmonary comorbidities also contribute substantially to poor asthma control and a heightened disease burden. These comorbidities have been proposed as "treatable traits" in chronic airways disease, adding impetus to their evaluation and management in difficult asthma. In this review, eight major asthma-related comorbidities are discussed: rhinitis, chronic rhinosinusitis, gastroesophageal reflux, obstructive sleep apnoea, vocal cord dysfunction, obesity, dysfunctional breathing and anxiety/depression. We describe the prevalence, impact and treatment effects of these comorbidities in the difficult asthma population, emphasizing gaps in the current literature. We examine the associations between individual comorbidities and highlight the potential for comorbidity clusters to exert combined effects on asthma outcomes. We conclude by outlining a pragmatic clinical approach to assess comorbidities in difficult asthma.

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“…Asthma is significantly associated with psychiatric disorders [1], especially depression that has been consistently reported to be prevalent in asthmatic patients [2–4]. Adeyeye et al [5] indicated that depression is the most important factor independently associated with asthma-related quality of life.…”

Section: Introductionmentioning

confidence: 99%

Abnormal Functional Connectivity of Ventral Anterior Insula in Asthmatic Patients with Depression

et al. 2017

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Objective To explore the underlying mechanism of depression in asthmatic patients, the ReHo in the insula and its FC was used to probe the differences between depressed asthmatic (DA) and nondepressed asthmatic (NDA) patients. Methods 18 DA patients, 24 NDA patients, and 60 healthy controls (HCs) received resting-state fMRI scan, severity of depression, and asthma control assessment. Results DA patients showed increased FC between the left ventral anterior insula (vAI) and the left middle temporal gyrus compared with both NDA and HC groups. In addition, compared with HCs, the DA and NDA patients both exhibited increased FC between the left vAI and the right anterior cingulate cortex (ACC), decreased FC between the left vAI and the bilateral parietal lobe, and increased FC between the right vAI and the left putamen and the right caudate, respectively. Furthermore, the increased FC between the left vAI and the right ACC could differentiate HCs from both DA and NDA patients, and the increased FC between the right vAI and both the left putamen and the right caudate could separate NDA patients from HCs. Conclusions This study confirmed that abnormal vAI FC may be involved in the neuropathology of depression in asthma. The increased FC between the left vAI and the left MTG could distinguish DA from the NDA and HC groups.

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The impact of anxiety and depression on outpatients with asthma

Abstract: The present real-life study indicates that anxiety and depression are common and relevant comorbidities in asthmatic outpatients and are associated with uncontrolled asthma and lower ACT scores. Thus, assessment of comorbid mental disorders should be performed in common practice.

Cited by 154 publications

References 45 publications

Severe and uncontrolled asthma in China: a cross-sectional survey from the Australasian Severe Asthma Network

Severe and uncontrolled asthma in China: a cross-sectional survey from the Australasian Severe Asthma Network

Comorbid “treatable traits” in difficult asthma: Current evidence and clinical evaluation

Abnormal Functional Connectivity of Ventral Anterior Insula in Asthmatic Patients with Depression

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