Psychological status in uncontrolled asthma is not related to airway hyperresponsiveness.
BACKGROUND
Airway hyperresponsiveness (AHR) is the characteristic functional abnormality of asthma, and previous studies have shown the potential for AHR to be influenced by psychological factors, yet the relationship between anxiety and/or depression and AHR remains unclear in patients with asthma.


OBJECTIVE
To explore the relationship between psychological status and AHR in asthma patients.


METHODS
In a cross-sectional study, 168 adult subjects were recruited with physician-diagnosed uncontrolled asthma and a positive result for AHR in methacholine (Mch) challenge test. Psychological status, asthma control, and asthma quality of life were assessed using Zung self-rating anxiety/depression scale, asthma control test (ACT), and asthma quality of life questionnaire (AQLQ), respectively. AHR severity was evaluated and quantified by the provocative concentration of Mch, which evoked a given decrease of 20% in FEV(1).


RESULTS
A total of 70.23% of recruited patients (n = 118) met the diagnostic criteria for anxiety and/or depression. There was a trend between negative psychological status and AHR in asthma patients that did not reach statistical significance, but no independent effects of negative mood states (anxiety, depression, or both) on AHR were established. Further, analyses revealed that only anxiety is associated with worse asthma control (p = 0.029), and a significant interaction effect of depression and anxiety accounted for lower asthma-related quality-of-life scores (p < 0.001).


CONCLUSIONS
AHR and psychological status are loosely related to each other even if in uncontrolled asthma.
Wang
Gang
G
Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China.
Wang
Lei
L
Szczepaniak
William S
WS
Xiong
Ze-Yu
ZY
Wang
Lan
L
Zhou
Ting
T
Fu
Juan-Juan
JJ
Liang
Bing-Miao
BM
Yuan
Yu-Ru
YR
Li
Tao
T
Ji
Yu-Lin
YL
D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D001526:Behavioral Symptoms / Q000453:epidemiology / Q000523:psychology*; D016535:Bronchial Hyperreactivity / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D001985:Bronchial Provocation Tests; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D004522:Educational Status; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011788:Quality of Life / Q000523:psychology; D012923:Social Class; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult