title: What is worse for asthma control and quality of life: depressive disorders, anxiety disorders, or both?
abstract: BACKGROUND
  The high burden of asthma appears to be related to poor asthma control. Although previous studies have reported associations between depressive disorders (DDs) and anxiety disorders (ADs) and worse asthma control and quality of life, the relative impact of these disorders on asthma control and quality of life has not been explored. This study evaluated the relative impact of having a DD and/or AD on asthma control and quality of life.
  
  
  METHODS
  Five hundred four consecutive adults with confirmed, physician-diagnosed asthma underwent a brief, structured psychiatric interview using the Primary Care Evaluation of Mental Disorders. Asthma control and asthma-related quality of life were assessed using the Asthma Control Questionnaire (ACQ) and the Asthma Quality of Life Questionnaire (AQLQ). All patients underwent standard spirometry.
  
  
  RESULTS
  Thirty-one percent of patients (n = 157) met the diagnostic criteria for one or more psychiatric disorders (8% had DD only, 12% had AD only, and 11% had both). Analyses revealed independent effects for DDs on total ACQ scores (p < 0.01), and for DDs and ADs on total AQLQ scores and all four AQLQ subscales (p < 0.05). There were no interaction effects.
  
  
  CONCLUSIONS
  Results suggest that DDs and ADs are associated with worse asthma-related quality of life, but only DDs are associated with worse asthma control. Interestingly, having both a DD and an AD did not confer additional risk for worse asthma control or quality of life. Physicians may want to consider the differential impact of negative mood states when assessing levels of asthma control and quality of life.
authors.affiliation: Research Center, Division of Chest Medicine, J-3190, 5400 Gouin West, Montreal, QC, H4J 1C5, Canada. k-lavoie@crhsc.rtss.qc.ca
authors.forename: Kim L
authors.initials: KL
authors.lastname: Lavoie
authors.forename: Simon L
authors.initials: SL
authors.lastname: Bacon
authors.forename: Silvana
authors.initials: S
authors.lastname: Barone
authors.forename: Andre
authors.initials: A
authors.lastname: Cartier
authors.forename: Blaine
authors.initials: B
authors.lastname: Ditto
authors.forename: Manon
authors.initials: M
authors.lastname: Labrecque
mesh_terms: D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001008:Anxiety Disorders / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D011792:Quebec; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D018927:Anti-Asthmatic Agents