title: Association of depression and anxiety with health care use and quality of life in asthma patients.
abstract: BACKGROUND
  Demographic factors, symptom severity, and psychopathology, in particular anxiety and depression, are known to influence health care use and quality of life in asthma. Because depression and anxiety are typically correlated, we sought to explore whether depression specifically is associated with health care utilization and quality of life when effects of anxiety are controlled for.
  
  
  METHODS
  In a cross-sectional questionnaire study, 88 asthma patients (46 women; age range 27-70 years) reported on symptoms and treatment of their disease, as well as anxiety and depression (Hospital Anxiety and Depression Scale, HADS), general quality of life (Short Form 12 Health Survey Questionnaire, SF-12) and asthmatic-specific quality of life (Living with Asthma, LAQ).
  
  
  RESULTS
  While no considerable associations between anxiety and health care use were found, the associations between higher scores in depression and hospital visits as well as days of corticosteroid intake were significant. Furthermore, considerable variance in all subscales of quality of life questionnaires was explained by higher scores in depression, even when controlling for anxiety. For anxiety scores these associations were comparable, except for physical well-being.
  
  
  CONCLUSIONS
  Depression is an important issue in asthma, as it is substantially related to quality of life and intake of corticosteroids, and marginally to hospitalization. Routine screening for depression should be considered in hospital and primary care.
authors.affiliation: Department of Psychology, Southern Methodist University, Dallas, TX 75205, USA. kullowatz@smu.edu
authors.forename: Antje
authors.initials: A
authors.lastname: Kullowatz
authors.forename: Frank
authors.initials: F
authors.lastname: Kanniess
authors.forename: Bernhard
authors.initials: B
authors.lastname: Dahme
authors.forename: Helgo
authors.initials: H
authors.lastname: Magnussen
authors.forename: Thomas
authors.initials: T
authors.lastname: Ritz
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D001249:Asthma / Q000188:drug therapy / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D000305:Adrenal Cortex Hormones