Psychiatric disorders in asthmatic outpatients

Nascimento, Isabella; Nardi, Antônio Egídio; Valença, Alexandre Martins; Lopes, Fabiana L.; Mezzasalma, Marco A.; Nascentes, Ronaldo; Zin, Walter A.

doi:10.1016/s0165-1781(02)00029-x

Cited by 125 publications

(81 citation statements)

References 29 publications

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“…In a previous study, 14 we found a high psychiatric morbidity (61.6%) in a sample of 90 asthmatic patients, mainly panic disorder/agoraphobia spectrum disorders (40.7%), generalized anxiety disorder (24.4%), major depression (33.7%) and social phobia (9.3%). In this first study, we found a high frequency of agoraphobia without panic disorder (26.8%).…”

Section: -11mentioning

confidence: 66%

The relationship between the severity of asthma and comorbidites with anxiety and depressive disorders

Valença

Falcão

Freire

et al. 2006

Rev. Bras. Psiquiatr.

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The relationship between the severity of asthma and comorbidites with anxiety and depressive disorders Relação entre a gravidade da asma e comorbidade com transtornos de ansiedade e depressão A b s t r a c t Objective: There is evidence that asthma is associated with increased frequency of psychiatric symptoms and mental disorders. Our aim was to assess the frequency of anxiety and depressive disorders in a sample of asthmatic outpatients and observe if there is any relationship between this comorbidity and the severity of asthma. Method: Sixty-two consecutive patients of two outpatient asthma clinics located in university hospitals were evaluated. Psychiatric diagnoses were assessed with the Mini-International Neuropsychiatric Interview 4.4 Version. Results: Twenty-seven patients (43.5%) met criteria for at least one psychiatric diagnosis. The most frequent diagnoses were major depression (24%), generalized anxiety disorder (20.9%) and panic disorder/agoraphobia spectrum disorders (17.7%). We found no significant differences in the prevalence of anxiety disorders and depression between the groups with mild/ moderate and severe asthma. Despite the high frequency of depression and anxiety disorders, only 4 (6.5%) patients were under psychiatric treatment and 13 (20.9%) patients were taking benzodiazepines. Twelve of 15 (80%) patients who reported present use of psychotropic medication were not under psychiatric treatment at the moment of the study. Conclusions: Our results support the high morbidity of anxiety and depressive disorders in asthmatic patients, independent of the severity of asthma. Keywords: Respiratory tract diseases; Respiratory insufficiency; Pulmonary disease (Specialty); Anxiety; Panic disorderResumo Objetivo: Existem evidências de que a asma está associada a um aumento da presença de sintomas psiquiátricos e de transtornos mentais. O objetivo do presente estudo é o de averiguar a freqüência de transtornos de ansiedade e depressão em uma amostra de pacientes asmáticos ambulatoriais e observar se há relação deste tipo de comorbidade com a gravidade da asma. Método: Sessenta e dois pacientes consecutivos de dois ambulatórios universitários especializados em asma foram examinados. Os diagnósticos psiquiátricos foram obtidos em entrevista com a utilização do Mini-International Neuropsychiatric Interview 4.4 Version. Resultados: Vinte e sete (43,5%) pacientes preencheram os critérios para ao menos um diagnóstico psiquiátrico. Os diagnósticos mais freqüentes foram depressão maior (24,0%), transtorno de ansiedade generalizada (20,9%) e transtornos do espectro pânico/agorafobia (17,7%). Não encontramos diferenças significativas na prevalência de transtornos de ansiedade e depressão entre os grupos com asma leve/moderada e com asma grave. Apesar da alta freqüência de depressão e transtornos de ansiedade, apenas 4 (6,5%) pacientes estavam em tratamento psiquiátrico e 13 (20,9%) estavam usando benzodiazepínicos. Doze dos 15 (80,0%) pacientes em uso de medicação psicotrópica não estavam em tratamento psiqu...

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Section: -11mentioning

confidence: 66%

The relationship between the severity of asthma and comorbidites with anxiety and depressive disorders

Valença

Falcão

Freire

et al. 2006

Rev. Bras. Psiquiatr.

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“…Each hypothetical case was characterised in terms of the impact of asthma on each of these domains. Symptoms were described in terms of wheeze, cough and breathlessness; emotions were defined in terms of anxiety, as this is the principle negative emotion associated with asthma [16]; disturbance to daily activity and to social life were undefined. Each cue was presented at one of four levels of severity.…”

Section: Judgement Analysismentioning

confidence: 99%

Analysis of the cues used by patients when making assessments of their asthma severity

Barley¹,

Jones

2005

European Respiratory Journal

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This study measured the relative contribution of four cues: symptoms, effect on activities, emotions and social life, to patients' judgments of overall asthma severity.Judgement analysis techniques were applied to patients' assessments of overall asthma severity using asthma states described in scenarios based on these cues.Altogether, 40 patients, mean age 52 yrs, mean forced expiratory volume in one second 67% predicted, were studied. The relative importance of the cues varied widely between patients; symptoms contributed to 47% of the judgment of asthma severity (range 15-86%), activities 19% (1-73%), emotions 14% (0-43%), and social life 19% (2-57%). Some patients had difficulty with the judgment task, they tended to be older or have worse health. A total of 21 patients had consistent judgment policies. Cluster analysis identified two policy types. In one, symptoms were weighted heavily, in the other all cues were weighted similarly. Policies were not related to disease or demographic factors.Symptoms are important cues for patients when assessing asthma severity, but other cues may be more important in some patients. Patients fall into two groups: those who rely on symptoms and those who use several cues.

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“…Recent population-based studies have shown that adults with asthma are more likely to have PD (2) and panic attacks (3) than adults without asthma. The prevalence rate of PD among patients with asthma has been estimated to range between 6.5 and 24%, depending on the sample studied (4)(5)(6)(7)(8). In contrast, the 1-year prevalence rate of PD is between 1 and 2% among the general population in the United States (9,10).…”

Section: Introductionmentioning

confidence: 99%

Health Care Use and Quality of Life Among Patients with Asthma and Panic Disorder

Feldman¹,

Lehrer²,

Borson³

et al. 2005

LJAS

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The purpose of this study was to assess the associations between panic disorder (PD) and health services use, health-related quality of life, and use of short-acting β 2 -agonists among individuals with asthma. We studied 21 adults with comorbid asthma and panic disorder (asthma-PD) and 27 asthma patients without PD (asthma-only). Participants attended a single session at a laboratory to complete the study. A retrospective chart review was conducted to assess use of health care resources for asthma treatment during the past 12 months. Patients completed the Asthma Quality of Life Questionnaire and lung function testing. Asthma-only and asthma-PD patients displayed no differences on asthma severity, as measured by spirometry and asthma medication class. Asthma-PD patients had more visits to their primary care physicians for asthma ( p < 0.01) and reported a lower quality of life related to asthma ( p < 0.01) and greater use of short-acting β 2 -agonists ( p < 0.05) than asthma-only patients. These findings were independent of pulmonary function, asthma medication class, and sociodemographic status. These data show that coexistence of PD in asthma is associated with increased use of primary care health resources and greater perceived impairment from asthma, independent of asthma severity. These findings indicate a need to develop interventions to improve quality of life and self-management of asthma among PD patients.

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Psychiatric disorders in asthmatic outpatients

Cited by 125 publications

References 29 publications

The relationship between the severity of asthma and comorbidites with anxiety and depressive disorders

The relationship between the severity of asthma and comorbidites with anxiety and depressive disorders

Analysis of the cues used by patients when making assessments of their asthma severity

Health Care Use and Quality of Life Among Patients with Asthma and Panic Disorder

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