Association Between Asthma and Depression: A National Cohort Study

Choi, Hyo Geun; Kim, Joohee; Park, Ji Young; Hwang, Yong Il; Jang, Seung Hun; Jung, Ki‐Suck

doi:10.1016/j.jaip.2018.10.046

Cited by 52 publications

(56 citation statements)

References 30 publications

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“…The comorbidity between asthma and the affective traits may, in part, be due to shared genetic influences between asthma and depression [33]. Thus, our study largely agrees with the findings from previous studies and even provides more convincing evidence on the need to understand the biological mechanism that explains the relationship between Asthma and DD for better treatment outcomes [34].…”

Section: Discussionsupporting

confidence: 91%

Correlates of depressive disorders and quality of life among older adults in six low and middle-income countries: WHO country-wide study on global ageing and adult health

Dwomoh

Amuasi²,

Incoom

et al. 2020

Preprint

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Background The diagnosis and treatment of Depressive Disorders (DD) remain a challenge in low and middle-income countries (LMICs). Identifying the most important correlate of DD would serve as a guide in the design and implementation of targeted intervention in resource-constrained LMICs. This study determined whether there is/are common risk factor(s) of DD across the six LMICs and whether there is a risk factor that can be ranked consistently as the most important predictor of DD in all the six LMICs. We further estimated the impact of DD on the quality of life (QoL).Methods We used data from the World Health Organization Study on Global Ageing and Adult Health. Weighted dominance analysis was performed to determine the most important risk factor of DD. We applied inverse probability weighting Poisson regression adjustment to estimate the impact of DD on QoL for each country and further estimated the overall effect of DD on QoL in the six countries by computing a weighted average of the country-specific estimate using the technique of meta-analysis.Results Among the 58 risk factors investigated, Asthma was the most common and the most important predictor of DD across all six LMICs. DD contributed to a 12% increase in the poor QoL in China, (prevalence difference (PD)=0.12; 95% CI: 0.07-0.18, p<0.001). In India (PD=0.08; 95% CI: 0.04-0.13, p<0.01) and Russian Federation (PD=0.08; 95% CI: 0.01-0.15, p<0.01). Although there was some increase in poor QoL in Mexico, Ghana, and South Africa due to DD, the increase was not statistically significant.Conclusions Asthma is a major contributing factor to the high prevalence of DD among older adults and could have a direct or indirect effect on QoL. We recommend integrated intervention for Asthma patients that incorporates the diagnosis and treatment of DD. Access to quality mental healthcare should be a major government priority in LMICs.

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Section: Discussionsupporting

confidence: 91%

Correlates of depressive disorders and quality of life among older adults in six low and middle-income countries: WHO country-wide study on global ageing and adult health

Dwomoh

Amuasi²,

Incoom

et al. 2020

Preprint

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“…The availability of accurate quantitative treatment data allowed us to explore the effect of asthma. As expected, the use of systemic oral corticosteroids, antihistamines, antibiotics and antidepressants was higher in patients with AD who required treatment for asthma (Table S4; see Supporting Information). However, unexpectedly, we also observed a small but statistically significant increase in the number of patients using TCS in this subgroup in all age ranges, but especially in older adults (Table ).…”

Section: Resultssupporting

confidence: 70%

Quantitative analysis of topical treatments in atopic dermatitis: unexpectedly low use of emollients and strong correlation of topical corticosteroid use both with depression and concurrent asthma

et al. 2019

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Summary Background Despite decades of use, the actual amounts of topical corticosteroids (TCS) and emollients used in moderate‐to‐severe atopic dermatitis (AD) under real‐world conditions are unknown. Thus, it remains unclear whether inadequate use is widespread. Objectives To quantify the use of TCS and emollients in moderate‐to‐severe AD. Methods Double‐blinded drug prescribing was recorded prospectively at the point of drug dispensing within a catchment area of approximately 450 000 people over a 31‐year period in a population‐based cohort marked by failure of disease control in primary care (n = 844). For each patient, prescribing was recorded over a 12‐month period in order to minimize fluctuations. Results This approach resulted in a near‐complete dataset, which was essentially free of reporting bias and recording bias. Atopic comorbidities matched expected frequencies. Median use of TCS was statistically significantly higher in juvenile patients (age < 16 years) compared with adult patients (49·2 vs. 38·1 g per month), in male vs. female patients (46·8 vs. 29·7 g per month) and in patients receiving concurrent asthma treatment (40·4 vs. 26·7 g per month). TCS use was strongly associated with antidepressant treatment. Emollient use was unexpectedly low with a median of 9·6 g per day (range 1·4–30·1). Results were replicated in an independent validation cohort. Conclusions Deficient use of emollients may be a factor contributing to AD severity. Our analysis showed that the use of TCS does not exceed current guidelines. Accurate quantification of topical treatments provides a widely accessible strategy to measure the real‐world impact of novel AD treatments. What's already known about this topic? Both emollient and topical corticosteroid (TCS) use have been a mainstay of atopic dermatitis (AD) treatment for over 60 years. The actual quantities used by patients under real‐world conditions are unknown. What does this study add? The real‐world use of emollients is fourfold lower than the amount recommended in current guidelines. Underuse of emollients may be a significant factor in disease exacerbation. The use of TCS is significantly higher in male patients and is higher in patients with AD who also have asthma. The use of TCS is strongly associated with concurrent antidepressant treatment.

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“…Stress or psychological distress, such as depression, due to asthma could increase an individual’s susceptibility to migraines and vice versa. Asthma was associated with a 1.35 times greater risk of depression in a previous study (95% CI = 1.31–1.40) 31 . Depression and stressful events are important modifiable risk factors for migraines 32 .…”

Section: Discussionmentioning

confidence: 52%

“…We adjusted for depression in the analysis due to its reciprocal association with asthma as revealed in our previous study 44 . Depression was classified as previously detailed 44 . CCI was counted, except for pulmonary disease, which includes asthma 45 .…”

Section: Methodsmentioning

confidence: 99%

Bidirectional association between asthma and migraines in adults: Two longitudinal follow-up studies

Kim

Min

et al. 2019

Sci Rep

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the objective of this study was to evaluate the bidirectional association between asthma and migraines using control subjects matched by demographic factors. the Korean Health insurance Review and Assessment Service-National Sample Cohort from 2002 to 2013 was used. In study I, 113,059 asthma participants were matched with 113,059 control I participants. In study II, 36,044 migraine participants were matched with 114,176 control II participants. The hazard ratios (HRs) of migraines in the asthma patients (study I) and asthma in the migraine patients (study II) were analyzed using stratified Cox proportional hazard models after adjusting for depression and the Charlson comorbidity index. In study I, 5.3% (6,017/ 113,059) of the asthma group and 3.4% (3,806/ 113,059) of the control I group had migraines (P < 0.001). The asthma group demonstrated an adjusted HR of 1.47 for migraine (95% confidence interval (CI) = 1.41-1.53, P < 0.001). In study II, 15.4% (5,548/36,044) of the migraine group and 10.6% (15,271/144,176) of the control group had asthma (P < 0.001). The migraine group showed an adjusted HR of 1.37 for asthma (95% CI = 1.33-1.41, P value < 0.001). Asthma and migraines are reciprocally associated. Asthma is a chronic airway disease associated with clusters of respiratory symptoms, including wheezing and dyspnea. Asthma is a common disease with different prevalences according to ethnicity that range from approximately 7% to 18.0% 1. The incidence of asthma in the adult population (>20 years old) was estimated to be approximately 3.63-6.07 per 1,000 people in Korea 2. Because the diagnosis of asthma is based on the functional deterioration of the lower airway, the underlying pathophysiologic causes of asthma have been reported to vary among asthmatic patients 3. According to the pathophysiologic mechanisms, asthma is classified as two major endotypes of T-helper type 2 cell (TH2)-high and TH2-low diseases 4. Thus, in addition to TH2-high related diseases, such as allergic rhinitis, other immune-related diseases could complicate asthma. In addition, both genetic factors and environmental triggering factors have been suggested to be related to asthma 5,6. Migraine disorder is another chronic disease characterized by multiple symptoms of headache and/or aura. As many as approximately 1.04 billion people suffer from migraines worldwide (95% uncertainty interval = 1.00-1.09) 7. In Korea, approximately 6.0% of the adult population (19-69 years) suffers from migraines 8. Migraines are characterized by recurrent episodic symptom sequences of a premonitory phase, an aura phase, a headache phase, and a postdrome phase 9. The environmental triggering factors can hyper-activate the hypothalamic-pituitary-adrenocortical axis and autonomic nervous system in migraine susceptible subjects 10. These hormonal and nervous changes induce vasodilation, the release of vascular factors, including growth factors, cytokines, nitric oxide, norepinephrine and calcitonin gene-related peptide, and interaction with endothelial cells, res...

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Association Between Asthma and Depression: A National Cohort Study

Cited by 52 publications

References 30 publications

Correlates of depressive disorders and quality of life among older adults in six low and middle-income countries: WHO country-wide study on global ageing and adult health

Correlates of depressive disorders and quality of life among older adults in six low and middle-income countries: WHO country-wide study on global ageing and adult health

Quantitative analysis of topical treatments in atopic dermatitis: unexpectedly low use of emollients and strong correlation of topical corticosteroid use both with depression and concurrent asthma

Bidirectional association between asthma and migraines in adults: Two longitudinal follow-up studies

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