Montreal Behavioural Medicine Centre, Research Centre, Hôpital du Sacré-Coeur de Montréal, affiliated with the University of Montreal, Canada.
Psychosom Med. 2011 Jul-Aug;73(6):504-13. doi: 10.1097/PSY.0b013e318222e9fc. Epub 2011 Jun 28.
Generalized anxiety disorder (GAD) is common among people with asthma, but its association with asthma morbidity remains unexplored. This study examined cross-sectional associations between GAD and asthma control, quality of life, and self-efficacy.
Seven hundred ninety-four adults with confirmed asthma were recruited from the outpatient clinic of a university hospital. Patients underwent a sociodemographic and medical history interview (to assess health service use and medications), followed by a brief psychiatric interview (Primary Care Evaluation of Mental Disorders) to assess GAD. Patients completed questionnaires assessing asthma control, quality of life, and asthma self-efficacy and underwent spirometry. General linear models and logistic regression were used to assess associations between GAD and asthma morbidity measures, adjusting for covariates.
GAD affected 4% of the sample. The analyses revealed significant associations between GAD and worse overall asthma control (β = 0.62, standard error [SE] = 0.18, p < .001), increased bronchodilator use (β = 10.60, SE = 2.64, p < .001), worse asthma quality of life (β = -0.91, SE = 0.23, p < .001), and worse asthma self-efficacy (β = -59.56, SE = 13.59, p < .001) after the adjustment for covariates. Separate sensitivity analyses including major depressive disorder and asthma self-efficacy as additional covariates rendered many of these associations nonsignificant. There were no associations between GAD and emergency visits or hospitalizations.
GAD is associated with worse asthma morbidity independent of age, sex, smoking, and asthma severity; however, comorbid major depressive disorder and low asthma self-efficacy may account for many of these associations. Only breathlessness and the frequency of bronchodilator use were uniquely associated with GAD. Future research should examine whether treatment of GAD can affect asthma outcomes.
广泛性焦虑障碍（GAD）在哮喘患者中很常见，但它与哮喘发病率的关系尚不清楚。本研究调查了 GAD 与哮喘控制、生活质量和自我效能之间的横断面关联。
从一家大学医院的门诊招募了 794 名确诊哮喘的成年人。患者接受了社会人口统计学和病史访谈（评估卫生服务利用和药物使用情况），随后进行了简短的精神科访谈（初级保健评估精神障碍）以评估 GAD。患者完成了评估哮喘控制、生活质量和哮喘自我效能的问卷，并进行了肺功能检查。使用一般线性模型和逻辑回归来评估 GAD 与哮喘发病率衡量指标之间的关联，同时调整了协变量。
GAD 影响了 4%的样本。分析结果显示，GAD 与总体哮喘控制较差（β=0.62，标准误差[SE]=0.18，p<.001）、支气管扩张剂使用增加（β=10.60，SE=2.64，p<.001）、哮喘生活质量更差（β=-0.91，SE=0.23，p<.001）和哮喘自我效能更差（β=-59.56，SE=13.59，p<.001）显著相关，在调整了协变量后。包括主要抑郁障碍和哮喘自我效能作为额外协变量的单独敏感性分析使许多这些关联变得不显著。GAD 与急诊就诊或住院治疗之间无关联。
GAD 与哮喘发病率较差相关，与年龄、性别、吸烟和哮喘严重程度无关；然而，共病的重度抑郁障碍和低哮喘自我效能可能解释了其中许多关联。只有呼吸困难和支气管扩张剂使用频率与 GAD 有独特的关联。未来的研究应探讨治疗 GAD 是否能改善哮喘的预后。
