Division of Respiratory Diseases, IRCCS "San Matteo" Hospital Foundation, University of Pavia, Pavia, Italy.
Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy; Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Unit of Epidemiology of Allergic and Respiratory Diseases (EPAR), F75012, Paris, France.
Respir Med. 2019 Aug;155:6-12. doi: 10.1016/j.rmed.2019.06.025. Epub 2019 Jun 30.
Although many studies have highlighted the link between asthma/rhinitis and depression, it is still unclear which characteristics of these diseases are associated with the risk of depression. We aimed to explore the relationship between depression and asthma or rhinitis in a representative sample of the Italian general population.
The data were collected in GEIRD, an Italian multicenter, population-based, multicase-control study. 2227 participants (age 21-86 years, female 50%) underwent standardized interviews, skin prick and lung function tests, and were divided into cases of current asthma (n = 528), rhinitis without asthma (n = 972), and controls (n = 727). Two specific questions from the Patient Health Questionnaire (PHQ-2) were asked to identify symptoms of depressed mood and anhedonia, which were used as a proxy of major depression disorder.
The prevalence of depression was 16.7%, 11.9%, and 5.1% in subjects with asthma, rhinitis and controls, respectively. Both in asthma and rhinitis, subjects with depression had worse respiratory-health related quality of life and more frequent disease-related symptoms than their non-depressed counterparts. In asthma, depression was associated with poorer disease control. In rhinitis, depression was significantly associated with a disease-related limitations in daily activities and greater risk of symptom exacerbations and prescriptions of medicines for breathing. Cases of rhinitis with depression were less likely to be atopic.
Our results suggest that rhinitis exacerbations, particularly in non-atopic subjects, and low asthma control are strongly related to the presence of depressed mood in adults from the general population.
尽管许多研究强调了哮喘/鼻炎与抑郁症之间的联系,但仍不清楚这些疾病的哪些特征与抑郁症的风险相关。我们旨在探索意大利普通人群代表性样本中哮喘或鼻炎与抑郁症之间的关系。
数据来自意大利多中心、基于人群的多病例对照研究 GEIRD。2227 名参与者(年龄 21-86 岁,女性占 50%)接受了标准化访谈、皮肤点刺和肺功能测试,并分为当前哮喘病例(n=528)、无哮喘鼻炎病例(n=972)和对照组(n=727)。使用患者健康问卷(PHQ-2)中的两个特定问题来识别情绪低落和快感缺失的症状,作为重性抑郁障碍的替代指标。
在哮喘、鼻炎和对照组患者中,抑郁症的患病率分别为 16.7%、11.9%和 5.1%。在哮喘和鼻炎中,有抑郁症状的患者的呼吸健康相关生活质量更差,且疾病相关症状更频繁。在哮喘中,抑郁与较差的疾病控制有关。在鼻炎中,抑郁与与疾病相关的日常活动受限以及症状恶化和呼吸药物处方的风险增加显著相关。有鼻炎且抑郁的患者不太可能是特应性的。
我们的研究结果表明,鼻炎恶化,特别是在非特应性患者中,以及哮喘控制不佳,与普通人群中成年人出现情绪低落密切相关。