Katz Patricia P, Morris Anne, Julian Laura, Omachi Ted, Yelin Edward H, Eisner Mark D, Blanc Paul D
Department of Medicine, University of California, San Francisco, California 94143-0936, USA.
Prim Care Respir J. 2010 Sep;19(3):223-30. doi: 10.4104/pcrj.2010.00012.
Individuals with asthma may be at increased risk of depression, but few studies have identified precursors to the onset of depression. The study goal was to identify risk factors for depression onset among a community-based sample of adults with asthma.
Data were obtained from three telephone interviews conducted at 2-yearly intervals on a longitudinal cohort of adults with asthma (n=439). The Center for Epidemiologic Studies Depression scale (CESD) was used to measure depressive symptoms. Multiple regression analyses tested associations of sociodemographic and health-related variables with depression prevalence (cross-sectional analyses) and incident depression (longitudinal analyses).
15% of subjects were classified as "depressed" (CESD> or =23) at each interview. Individuals depressed at baseline were more likely to drop out (OR=1.76 [95% CI 1.05, 2.96]). Low perceived control of asthma (measured with the Perceived Control of Asthma Questionnaire [PCAQ]) exhibited the most consistent association with depression. Lower PCAQ was cross-sectionally associated with depression (OR=0.51 per 0.5 SD difference in PCAQ [0.35, 0.75]). Onset of depression was noted in 38 individuals. Decrease in perceived control at follow-up was associated with depression onset (OR=7.47 [2.15, 26.01]).
Low perceived control of asthma predicted depression onset among adults with asthma. This risk factor may respond to self-management education.
哮喘患者可能患抑郁症的风险增加，但很少有研究确定抑郁症发作的先兆。本研究的目的是在一个以社区为基础的成年哮喘患者样本中确定抑郁症发作的风险因素。
数据来自对一组成年哮喘患者（n = 439）每两年进行一次的三次电话访谈。采用流行病学研究中心抑郁量表（CESD）来测量抑郁症状。多元回归分析检验了社会人口统计学和健康相关变量与抑郁症患病率（横断面分析）和新发抑郁症（纵向分析）之间的关联。
每次访谈时，15%的受试者被归类为“抑郁”（CESD≥23）。基线时抑郁的个体更有可能退出（OR = 1.76 [95% CI 1.05, 2.96]）。哮喘自我控制感低（用哮喘自我控制感问卷[PCAQ]测量）与抑郁症的关联最为一致。PCAQ得分越低，与抑郁症的横断面关联越强（PCAQ每相差0.5个标准差，OR = 0.51 [0.35, 0.75]）。有38人出现抑郁症发作。随访时自我控制感下降与抑郁症发作有关（OR = 7.47 [2.15, 26.01]）。
哮喘自我控制感低可预测成年哮喘患者抑郁症的发作。这一风险因素可能对自我管理教育有反应。
