Prevalence and Risk Factors for Depression in Korean Adult Patients with Asthma: Is There a Difference between Elderly and Non-Elderly Patients?

Abstract

Depression is an important comorbidity of asthma. However, little information is available about depression and its potential impact on asthma control in Korean adult asthma patients. We aimed to estimate the prevalence and risk factors for depression in Korean adults with persistent asthma. The 127 non-elderly (20-64 yr) and 75 elderly (≥65 yr) patients with asthma were recruited. Demographic and clinical data were extracted, and the patients completed the Asthma Specific Quality of Life (AQOL) questionnaire and asthma control test (ACT). Depression status was defined using the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Depression was more prevalent in non-elderly (18.9%) than in elderly patients with asthma (13.3%). Patients with depression were significantly younger, had lower economic status, shorter disease duration, poorer asthma control, and worse AQOL scores (P<0.05). Within the non-elderly group, younger age and shorter disease duration were significantly associated with depression (P<0.05). Within the elderly group, a higher body mass index and current smoking status were significantly associated with depression (P<0.05). The PHQ-9 score was significantly correlated with worse ACT and AQOL scores in both groups. In conclusion, depression is strongly associated with poor asthma control and quality of life in Korean adult asthma patients. Our results provide important clues that used to target modifiable factors which contribute to development of depression in asthma patients.Graphical Abstract

Valid group comparisons can be made with the Patient Health Questionnaire (PHQ-9): A measurement invariance study across groups by demographic characteristics

“…With respect to measurement invariance by educational level and marital status, it is not possible to identify a plausible psychological or biological mechanism that could justify a possible violation of invariance. However, these analyzes are necessary because of their impact on practice since several studies make comparisons between these groups [13, 14]. Our results, like those developed in the Spanish study, support making comparisons validity between age, educational level, and marital status.…”

“…Measurement invariance has been little studied in the Patient Health Questionnaire-9 (PHQ-9) [11], a self-administered version of PRIME-MD for common mental disorders that evaluates each of the nine depression criteria from the DSM-IV [12] (these criteria are maintained in the DSM-V). Many population studies on depression have used the PHQ-9 for group comparisons [13, 14]. However, because measurement invariance between groups has not been evaluated in these studies, differences between groups may reflect measurement bias rather than true differences in depression [10].…”

“…However, there are no studies on PHQ-9’s measurement invariance across urban/rural areas or socioeconomic status. Despite this scant evidence, several studies make comparisons between these groups using the PHQ-9 [13, 14]. Ultimately, the empirical evidence on the measurement invariance of the PHQ-9 across these demographic characteristics is still insufficient.…”

Epidemiology of Depression and Associated Factors among Asthma Patients in Addis Ababa, Ethiopia

“…In Nigeria study participants were between 10 and 49 age ranges but in current study patients below 18 years old were not included. Approximately comparative figure was obtained in 2014 in Korea (16.8%) which applied the same tool [ 27 ].…”

Associação entre depressão e qualidade de vida em idosos: atenção primária à saúde [Association between depression and quality of life in older adults: primary health care]

“…Muitos fatores de risco para depressão têm sido identificados na literatura nesse segmento populacional, tais como, sexo feminino 6,7 ; cor da pele amarela, parda ou indígena; menor classificação econômica; aposentados, com histórico de problemas cardíacos, com incapacidade para atividades básicas e instrumentais da vida diária 6 ; baixa escolaridade 7 ; pior autopercepção de saúde e insatisfação em sua vida em geral 6,7 ; índice de massa corporal elevado e tabagismo 8 . Sintomatologia depressiva está associada com aumento do risco de demência…”