Eisner Mark D, Katz Patricia P, Lactao Gretchen, Iribarren Carlos
Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California 94117, USA.
Ann Allergy Asthma Immunol. 2005 May;94(5):566-74. doi: 10.1016/S1081-1206(10)61135-0.
Psychological disorders, including depression, are common in adults with asthma. Although depression is treatable, its impact on longitudinal asthma outcomes is not clear.
To elucidate the impact of depressive symptoms on patient-centered outcomes and emergency health care use in adults with asthma.
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.
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% CI, 1.05-2.0).
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.
心理障碍，包括抑郁症，在成年哮喘患者中很常见。尽管抑郁症是可治疗的，但其对哮喘长期预后的影响尚不清楚。
阐明抑郁症状对成年哮喘患者以患者为中心的预后以及紧急医疗保健使用情况的影响。
我们对743名因哮喘住院后招募的成年哮喘患者进行了一项前瞻性队列研究。抑郁症状被定义为在流行病学研究中心抑郁量表上得分16分或更高。我们研究了抑郁症状对以患者为中心的预后（经过验证的哮喘严重程度评分、马克斯哮喘生活质量问卷和12项简短健康调查身体成分汇总评分）以及从计算机数据库确定的未来哮喘紧急医疗保健使用情况的影响。
成年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/民族、教育程度和吸烟因素后，抑郁症状与更高的哮喘严重程度评分相关（平均评分增加2.6分；95%CI，1.8-3.4分）。此外，抑郁症状与较差的哮喘特异性生活质量（平均评分增加19.9分；95%CI，17.7-22.1分）和较差的身体健康状况（平均评分降低3.7分；95%CI，1.5-5.8分）相关。抑郁症状与哮喘住院的更大纵向风险相关（风险比，1.34；95%CI，0.98-1.84）。在控制哮喘预防保健的差异后，这种关系更强（风险比，1.45；95%CI，1.05-2.0）。
抑郁症状在成年哮喘患者中很常见，并且与较差的健康预后相关，包括更高的哮喘严重程度和哮喘住院风险。
