Impact of depressive symptoms on adult asthma outcomes
Impact of depressive symptoms on adult asthma outcomes
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DOI：
10.1016/s1081-1206(10)61135-0
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发表时间：
2005-05-01
影响因子：
5.9
通讯作者：
Iribarren, C
中科院分区：
文献类型：
--
作者：
Eisner, MD;Katz, PP;Iribarren, C
背景：包括抑郁在内的心理障碍在成人哮喘患者中很常见。虽然抑郁症是可治疗的，其对纵向哮喘outcomes的影响尚不清楚。Objective：To elaborate the impact of depression symptoms on patient centered outcomes and emergency health care use in adults with asthma.Methods：我们进行了一项前瞻性队列研究，743名成年哮喘患者因哮喘住院后被招募。抑郁症状被定义为在流行病学研究中心抑郁量表上得分为16分或以上。我们研究了抑郁症状对以患者为中心的结果的影响（经验证的哮喘严重程度评分、Marks哮喘生活质量问卷和12项健康调查简表身体成分汇总评分）以及从计算机数据库中确定的未来哮喘紧急医疗保健使用。在成人哮喘患者中，抑郁症状的患病率为18%（95%置信区间[CI]，15%-21%）。在控制了年龄、性别、种族、教育程度和吸烟情况后，抑郁症状与哮喘严重程度评分较高相关（平均评分增量，2.6分; 95%CI，1.8-3.4分）。此外，抑郁症状与哮喘特异性生活质量较差（平均评分增量，19.9分; 95%CI，17.7-22.1分）和身体健康状况较差（平均评分减量，3.7分; 95%CI，1.5-5.8分）相关。抑郁症状与因哮喘住院的纵向风险较大相关（风险比，1.34; 95%CI，0.98-1.84）。在控制了哮喘预防护理的差异后，这种关系更强（风险比，1.45; 95%CI，1.05-2.0）。结论：抑郁症状在成人哮喘患者中很常见，并且与较差的健康结局相关，包括更严重的哮喘和因哮喘住院的风险。
Background: Psychological disorders, including depression, are common in adults with asthma. Although depression is treatable, its impact on longitudinal asthma outcomes is not clear.Objective: To elucidate the impact of depressive symptoms on patient-centered outcomes and emergency health care use in adults with asthma.Methods: We conducted a prospective cohort study of 743 adults with asthma who were recruited after hospitalization for asthma. Depressive symptoms were defined as having a score of 16 or more on the Center for Epidemiologic Studies Depression Scale. We examined the impact of depressive symptoms on patient-centered outcomes (validated severity-of-asthma score, Marks Asthma Quality of Life Questionnaire, and 12-Item Short-Form Health Survey physical component summary score) and on future emergency health care use for asthma ascertained from computerized databases.Results: The prevalence of depressive symptoms was 18% (95% confidence interval [CI], 15%-21%) among adults with asthma. Depressive symptoms were associated with greater severity-of-asthma scores after controlling for age, sex, race/ ethnicity, educational attainment, and cigarette smoking (mean score increment, 2.6 points; 95% CI, 1.8-3.4 points). Furthermore, depressive symptoms were associated with poorer asthma-specific quality of life (mean score increment, 19.9 points; 95% CI, 17.7-22.1 points) and poorer physical health status (mean score decrement, 3.7 points; 95% CI, 1.5-5.8 points). Depressive symptoms were associated with a greater longitudinal risk of hospitalization for asthma (hazard ratio, 1.34; 95% CI, 0.98-1.84). After controlling for differences in preventive care for asthma, the relationship was stronger (hazard ratio, 1.45; 95% Cl, 1.05-2.0).Conclusion: Depressive symptoms are common in adults with asthma and are associated with poorer health outcomes, including greater asthma severity and risk of hospitalization for asthma.