The impact of depressive symptoms on the functional status of inner-city patients with asthma.
BACKGROUND
Functional deficits are common in patients with asthma. If there is cooccurring depression, these deficits may be more severe and/or more persistent.


OBJECTIVE
This study was undertaken to determine 1) the prevalence and severity of depressive symptoms in a sample of inner-city patients being treated for asthma and 2) the impact of these symptoms on functional status.


METHODS
Three hundred seventeen enrollees in an inner-city asthma program were evaluated using the health status questionnaire and the Center for Epidemiologic Studies Depression Scale (CES-D) at baseline and at 3- and 6-month follow-ups. Two groups were created based on patients' CES-D baseline scores, using a commonly used cutpoint to define "caseness" for depression. The two groups were compared using ANOVA, chi2, and the general linear model for repeated measures.


RESULTS
Of the sample, 55.01% had a CES-D score greater than the cutpoint for depression. The mean was 29.3 +/- 11.95, well above the scores commonly used to indicate the presence of depression. The depressed group had lower scores on many measures of functional capacity at baseline; whereas both depressed and nondepressed patients improved over time on the physical performance measure (the physical performance measure subscale of the health status questionnaire), the mean score for the depressed group was consistently lower.


CONCLUSIONS
The prevalence of depressive symptoms was greater than expected. Depression was persistent and had a major impact on functional capacity. Routine depression screening may be especially important in inner-city patients and other groups thought to be at increased risk for poor outcome.
Goethe
J W
JW
Burlingame Center for Psychiatric Research and Education, Institute of Living, Hartford, CT 06106, USA. jgoethe@harthosp.org
Maljanian
R
R
Wolf
S
S
Hernandez
P
P
Cabrera
Y
Y
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014505:Urban Population