MSc, Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Ludolf-Krehl-Strasse 7-11, 68167 Mannheim, Germany.
Psychosom Med. 2010 Apr;72(3):309-15. doi: 10.1097/PSY.0b013e3181d2f0f1. Epub 2010 Feb 26.
To investigate the association between depressive symptoms, social support, and prevalent as well as incident asthma. Depressive symptoms and social support may affect the development of asthma. This relationship could be mediated by health behaviors and/or inflammatory processes. Evidence from prospective cohort studies on depressive symptoms and social support in relation to asthma risk in adults remains sparse.
Between 1992 and 1995, a population-based sample of 5114 middle-aged adults completed questionnaires covering depressive symptoms, social support, self-reported asthma, and potential confounders. Among those alive in 2002/2003, 4010 (83%) were followed-up by questionnaires. Associations with prevalent and incident asthma were estimated by prevalence ratios (PR) and risk ratios (RR) along with corresponding 95% confidence intervals (CIs), using Poisson regression. PRs and RRs were adjusted for demographics, family history of asthma, smoking, alcohol consumption, body mass index, and physical exercise.
Cross-sectional analyses indicated that the prevalence of asthma was positively associated with depressive symptoms and inversely related to social support. Prospective analysis suggested a 24% increased risk of asthma with each 1-standard deviation increase in depressive symptoms (RR, 1.24; 95% CI, 1.02, 1.50), whereas the social support z score showed an inverse association with asthma incidence (RR, 0.71; 95% CI, 0.58, 0.88). Analyses with tertiles suggested similar, but nonsignificant, associations. Omitting health-related life-style variables from the multivariable models did not substantially alter these associations.
Risk of adult asthma was found to increase with depressive symptoms and to decrease with social support. These associations do not seem to be explained by health-related life-style factors.
探讨抑郁症状、社会支持与现患及新发哮喘之间的关系。抑郁症状和社会支持可能影响哮喘的发生。这种关系可能通过健康行为和/或炎症过程来介导。关于抑郁症状和社会支持与成人哮喘风险之间关系的前瞻性队列研究证据仍然很少。
在 1992 年至 1995 年间，采用基于人群的样本对 5114 名中年成年人进行了问卷调查，内容涵盖抑郁症状、社会支持、自我报告的哮喘以及潜在的混杂因素。在 2002/2003 年仍存活的人群中，通过问卷调查对 4010 人（83%）进行了随访。采用泊松回归估计现患和新发哮喘的关联，使用患病率比（PR）和风险比（RR）及其相应的 95%置信区间（CI）。PR 和 RR 经人口统计学、哮喘家族史、吸烟、饮酒、体重指数和体育锻炼调整。
横断面分析表明，哮喘的患病率与抑郁症状呈正相关，与社会支持呈负相关。前瞻性分析表明，抑郁症状每增加 1 个标准差，哮喘的风险增加 24%（RR，1.24；95%CI，1.02，1.50），而社会支持 z 分数与哮喘发病率呈负相关（RR，0.71；95%CI，0.58，0.88）。采用三分位数的分析提示了类似但无统计学意义的关联。将与健康相关的生活方式变量从多变量模型中排除并不会显著改变这些关联。
发现成人哮喘的风险随着抑郁症状的增加而增加，随着社会支持的增加而降低。这些关联似乎与与健康相关的生活方式因素无关。
