Anxiety but not depression symptoms are associated with greater perceived dyspnea in asthma during bronchoconstriction
Anxiety but not depression symptoms are associated with greater perceived dyspnea in asthma during bronchoconstriction
复制标题
焦虑而非抑郁症状与支气管收缩期间哮喘患者的呼吸困难程度增加相关。
DOI：
10.2500/aap.2015.36.3897
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发表时间：
2015-11-01
影响因子：
2.8
通讯作者：
Wang, Gang
中科院分区：
文献类型：
--
作者：
Li, Hong Lin;He, Xiao Li;Wang, Gang
目的：确定焦虑和抑郁是否与哮喘患者更严重的呼吸道不适有关。方法：成人哮喘患者（n = 230）接受乙酰甲胆碱（Mch）激发。在研究开始时，分别使用医院焦虑和抑郁量表、哮喘控制测试和哮喘生活质量问卷评估焦虑和抑郁、哮喘控制和生活质量。呼吸困难，呼吸困难强度（改良博格量表和视觉模拟量表[VAS]），和其他呼吸道症状的定性描述符进行了评估之前和之后的Mch challenge.Results：患者分为既不焦虑也不抑郁（NAD），焦虑，抑郁（D），或焦虑和抑郁（AD）根据医院焦虑和抑郁量表评分。哮喘控制测试和哮喘控制测试以及哮喘生活质量问卷得分在AD组中最低（均p < 0.001）。Mch激发前AD组的呼吸困难和喘息VAS评分最高（均p < 0.05）。Mch激发后AD组改良博格量表评分的增加（平均值[标准差] 2.5 ± 2.0）高于NAD组（1.5 ± 1.5）和D组（0.8 ± 0.9）（分别为p = 0.006和p = 0.003）。大多数呼吸困难的描述在焦虑组、D组和AD组中比在NAD组中更普遍。多变量逻辑回归模型表明，焦虑增加呼吸困难的风险（优势比1.10，P < 0.001的博格评分;优势比3.84，P = 0.032的VAS评分），但不为其他呼吸症状。结论：焦虑，而不是抑郁症与更大的感知呼吸困难强度，但没有其他措施的呼吸不适的哮喘患者。焦虑可能影响呼吸负荷一定时呼吸困难的程度和程度。
Objective: To determine whether anxiety and depression are associated with greater respiratory discomfort in asthma.Methods: Adults with asthma (n = 230) underwent methacholine (Mch) challenge. Anxiety and depression, asthma control, and quality of life were evaluated at study entry by using the Hospital Anxiety and Depression Scale, Asthma Control Test, and Asthma Quality of Life Questionnaire, respectively. Qualitative descriptors of breathlessness, dyspnea intensity (modified Borg scale and visual analog scale [VAS]), and other respiratory symptoms were evaluated before and after Mch challenge.Results: Patients were classified as neither anxiety nor depression (NAD), anxiety only, depression only (D), or both anxiety and depression (AD) according to the Hospital Anxiety and Depression Scale score. Asthma Control Test and Asthma Control Test, and Asthma Quality of Life Questionnaire scores were lowest in the AD group (both p < 0.001). VAS scores for dyspnea and wheezing before Mch challenge were highest in the AD group (both p < 0.05). The increase in the modified Borg scale score after Mch challenge was higher in the AD group (mean [standard deviation] 2.5 +/- 2.0) than in the NAD (1.5 +/- 1.5) and D (0.8 +/- 0.9) groups (p = 0.006 and p = 0.003, respectively). Most descriptors of breathlessness were more prevalent in the anxiety only, D, and AD groups than in the NAD group. Multivariable logistic regression models indicated that anxiety increased the risk of dyspnea (odds ratio 1.10, p < 0.001 for the Borg score; odds ratio 3.84, p = 0.032 for the VAS score) but not for other respiratory symptoms.Conclusions: Anxiety but not depression was associated with greater perceived dyspnea intensity but not other measures of respiratory discomfort in individuals with asthma. Anxiety may shape the quality and intensity of dyspnea at a given respiratory load.