Morrison Kristine M., Goli Arezou, Van Wagoner John, Brown E Sherwood, Khan David A.
Science Teacher Access to Resources at Southwestern Program and the Departments of Internal Medicine and Psychiatry, University of Texas Southwestern Medical Center, Dallas.
Prim Care Companion J Clin Psychiatry. 2002 Oct;4(5):174-177. doi: 10.4088/pcc.v04n0501.
Asthma is a sometimes severe respiratory illness with an increased prevalence, especially in low-income, minority, and inner-city populations, over the past 2 decades. Prior reports have suggested a link between depression and asthma deaths. However, no studies have examined the relationship between objective measures of asthma severity and clinician-rated depressive symptom severity. METHOD: In this pilot study, 46 children receiving treatment at an inner-city asthma clinic were assessed with the Children's Depression Rating Scale, Revised (CDRS-R). The current percentage of forced expiratory volume in 1 second (FEV(1)%) predicted and the inhaled steroid dose were recorded, as were oral steroid use, emergency room visits, and hospitalizations in the preceding year. RESULTS: Depressive symptoms were common in this sample, with 30% (N = 14) of the participants having CDRS-R scores consistent with likely, very likely, or almost certain major depressive disorder. When mean CDRS-R scores were compared between the sample divided by these asthma severity measures, only hospitalizations in the past year was associated with higher depressive symptom scores (p =.03). CONCLUSION: These findings suggest that in the patient sample studied, depressive symptoms appear to be common. However, depressive symptom severity is related only to hospitalization, not other measures of asthma severity. Larger studies are needed to confirm these findings and determine if other variables such as family history of depression or subjective assessment of asthma severity explain the high prevalence of depressive symptoms in these patients.
哮喘是一种有时较为严重的呼吸系统疾病,在过去20年中其患病率有所上升,尤其是在低收入、少数族裔和市中心城区人群中。先前的报告表明抑郁症与哮喘死亡之间存在联系。然而,尚无研究探讨哮喘严重程度的客观指标与临床医生评定的抑郁症状严重程度之间的关系。方法:在这项试点研究中,使用儿童抑郁评定量表修订版(CDRS-R)对46名在市中心城区哮喘诊所接受治疗的儿童进行了评估。记录了1秒用力呼气容积(FEV(1)%)的预测当前百分比、吸入类固醇剂量,以及前一年的口服类固醇使用情况、急诊就诊次数和住院次数。结果:该样本中抑郁症状较为常见,30%(N = 14)的参与者的CDRS-R得分与可能、很可能或几乎确定的重度抑郁症相符。当根据这些哮喘严重程度指标将样本分组并比较平均CDRS-R得分时,仅过去一年的住院次数与较高的抑郁症状得分相关(p = 0.03)。结论:这些发现表明,在所研究的患者样本中,抑郁症状似乎较为常见。然而,抑郁症状严重程度仅与住院情况相关,与哮喘严重程度的其他指标无关。需要开展更大规模的研究来证实这些发现,并确定诸如抑郁症家族史或哮喘严重程度的主观评估等其他变量是否可以解释这些患者中抑郁症状的高患病率。