The impact of clinical and psychological factors on asthma control: the experience of a single asthma center in Poland

Przybyszowski, Marek; Piliński, Rafał; Śliwka, Agnieszka; Polczyk, Romuald; Nowobilski, Roman; Sładek, Krzysztof; Bochenek, Grażyna

doi:10.1080/02770903.2020.1841791

Cited by 2 publications

(3 citation statements)

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“…The anxiety alone and depression alone groups were both associated with worse disease-related questionnaire scores. While the association between anxiety and depression with poorer questionnaire scores has been well described in asthma [ 4 , 12 , 30 ], our findings extend it to difficult asthma, where the evidence is sparse. However, worse questionnaire scores were the only commonality shared between the two groups.…”

Section: Discussionsupporting

confidence: 76%

“…Together, this highlights that the co-existence of both anxiety and depression has poor implications in difficult asthma, both physically and psychologically. Indeed, most other studies investigating the impact of psychological comorbidities in asthma of varying severity have focussed on anxiety and depression in combination, which is associated with poorer outcomes [ 4 , 5 , 8 , 9 , 12 , 30 ]. Additionally, our study of biologics use in WATCH found that these psychological comorbidities were associated with a poor biologics response [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

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The Detrimental Clinical Associations of Anxiety and Depression with Difficult Asthma Outcomes

Fong

Rafiq

Harvey³

et al. 2022

JPM

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Difficult asthma describes asthma in which comorbidities, inadequate treatment, suboptimal inhaler technique and/or poor adherence impede good asthma control. The association of anxiety and depression with difficult asthma outcomes (exacerbations, hospital admissions, asthma control, etc.) is unclear. This study assessed the clinical associations of anxiety and depression with difficult asthma outcomes in patients with a specialist diagnosis of difficult asthma. Using real-world data, we retrospectively phenotyped patients from the Wessex Asthma Cohort of Difficult Asthma (N = 441) using clinical diagnoses of anxiety and depression against those without anxiety or depression (controls). Additionally, we stratified patients by severity of psychological distress using the Hospital Anxiety and Depression Scale (HADS). We found that depression and/or anxiety were reported in 43.1% of subjects and were associated with worse disease-related questionnaire scores. Each psychological comorbidity group showed differential associations with difficult asthma outcomes. Anxiety alone (7.9%) was associated with dysfunctional breathing and more hospitalisations [anxiety, median (IQR): 0 (2) vs. controls: 0 (0)], while depression alone (11.6%) was associated with obesity and obstructive sleep apnoea. The dual anxiety and depression group (23.6%) displayed multimorbidity, worse asthma outcomes, female predominance and earlier asthma onset. Worse HADS-A scores in patients with anxiety were associated with worse subjective outcomes (questionnaire scores), while worse HADS-D scores in patients with depression were associated with worse objective (ICU admissions and maintenance oral corticosteroid requirements) and subjective outcomes. In conclusion, anxiety and depression are common in difficult asthma but exert differential detrimental effects. Difficult asthma patients with dual anxiety and depression experience worse asthma outcomes alongside worse measures of psychological distress. There is a severity-gradient association of HADS scores with worse difficult asthma outcomes. Collectively, our findings highlight the need for holistic, multidisciplinary approaches that promote early identification and management of anxiety and depression in difficult asthma patients.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

The Detrimental Clinical Associations of Anxiety and Depression with Difficult Asthma Outcomes

Fong

Rafiq

Harvey³

et al. 2022

JPM

View full text Add to dashboard Cite

show abstract

“…The acceptable internal consistency of the LOT-R was reported as Cronbach’s α of 0.82 ( Shifren and Anzaldi, 2018 ) in the stroke population, and stability (test–retest reliability) over a 4-month period in college students was reported as r = 0.79 ( Scheier et al, 1994 ). A scoring range of 0 to 13 points indicates a low level of optimism, whereas a range of 14 to 18 points suggests moderate optimism, and 19 to 24 points signifies a high level of optimism ( Przybyszowski et al, 2022 ). In this study, the scale demonstrated good reliability with a Cronbach’s alpha of 0.79.…”

Section: Methodsmentioning

confidence: 99%

Optimism and mental health in college students: the mediating role of sleep quality and stress

Lai,

Tsai,

Jarustanaput

et al. 2024

Front. Psychol.

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ObjectiveCollege students showed a high prevalence of stress, anxiety, and depression, with medical and nursing students experiencing particularly elevated levels of mental health challenges.Optimism significantly influences overall well-being by promoting a healthy lifestyle and cognitive responses. However, the association of optimism with sleep quality, stress, and mental health in college students remains unexplored. This study aimed to (1) explore the associations of optimism with sleep quality, stress, and mental health and (2) ascertain whether sleep quality and stress mediate the association between optimism and mental health among college students.MethodsA cross-sectional study was conducted using online surveys with students from health science majors at a public university in the northeast United States from September to December 2022. A total of 222 students participated in the study, providing data on sociodemographics, optimism, sleep quality, stress, anxiety, and depression. Parallel and serial mediation models were utilized to examine the potential mediating roles of sleep quality and stress in the association between optimism and mental health.ResultsThe study found that optimism influences anxiety and depression through both direct and indirect pathways. In line with predictions, the parallel mediation analysis revealed that the impact of optimism on anxiety (βtotal = −0.598, 95% confident interval [CI]: −0.778 to −0.392) and depression (βtotal = −0.724, 95% CI: −0.919 to −0.519) was mediated by stress and sleep quality. Furthermore, the serial mediation models revealed that stress and sleep quality co-mediated the relationship betweenoptimism and anxiety (indirect effect [IE] = −0.074, 95% CI: −0.135 to −0.029) or depression (IE = −0.084, 95% CI: −0.142 to −0.036) in a sequential manner.ConclusionOptimism was negatively correlated with poor sleep quality, stress, anxiety, and depression. Enhanced optimism was linked to high sleep quality and less stress, anxiety, and depression. These insights emphasize the potential for school-based optimism interventions to improve sleep quality, ameliorate stress-related concerns, and alleviate mental health challenges in college students.

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The impact of clinical and psychological factors on asthma control: the experience of a single asthma center in Poland

Cited by 2 publications

References 50 publications

The Detrimental Clinical Associations of Anxiety and Depression with Difficult Asthma Outcomes

The Detrimental Clinical Associations of Anxiety and Depression with Difficult Asthma Outcomes

Optimism and mental health in college students: the mediating role of sleep quality and stress

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