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What Is Worse for Asthma Control and Quality of Life^*

Depressive Disorders, Anxiety Disorders, or Both?

^* From the Research Center (Drs. Cartier and Labrecque, and Ms. Barone), Division of Chest Medicine, Hôpital du Sacré-Cur de Montréal; Department of Psychology (Dr. Lavoie), University of Quebec at Montreal; Department of Exercise Science (Dr. Bacon), Concordia University; and Department of Psychology (Dr. Ditto), McGill University, Montreal, QC, Canada.

Correspondence to: Kim L. Lavoie, PhD, Research Center, Division of Chest Medicine, J-3190, 5400 Gouin West, Montreal, QC, H4J 1C5, Canada; e-mail: k-lavoie{at}crhsc.rtss.qc.ca

Abstract

Background: The high burden of asthma appears to be related to poor asthma control. Although previous studies have reported associations between depressive disorders (DDs) and anxiety disorders (ADs) and worse asthma control and quality of life, the relative impact of these disorders on asthma control and quality of life has not been explored. This study evaluated the relative impact of having a DD and/or AD on asthma control and quality of life.

Method: Five hundred four consecutive adults with confirmed, physician-diagnosed asthma underwent a brief, structured psychiatric interview using the Primary Care Evaluation of Mental Disorders. Asthma control and asthma-related quality of life were assessed using the Asthma Control Questionnaire (ACQ) and the Asthma Quality of Life Questionnaire (AQLQ). All patients underwent standard spirometry.

Results: Thirty-one percent of patients (n = 157) met the diagnostic criteria for one or more psychiatric disorders (8% had DD only, 12% had AD only, and 11% had both). Analyses revealed independent effects for DDs on total ACQ scores (p < 0.01), and for DDs and ADs on total AQLQ scores and all four AQLQ subscales (p < 0.05). There were no interaction effects.

Conclusions: Results suggest that DDs and ADs are associated with worse asthma-related quality of life, but only DDs are associated with worse asthma control. Interestingly, having both a DD and an AD did not confer additional risk for worse asthma control or quality of life. Physicians may want to consider the differential impact of negative mood states when assessing levels of asthma control and quality of life.

Key Words: anxiety disorders • asthma control • depression • depressive disorders • quality of life

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