Onset of depressive symptoms among adults with asthma: results from a longitudinal observational cohort.
OBJECTIVE
Individuals with asthma may be at increased risk of depression, but few studies have identified precursors to the onset of depression. The study goal was to identify risk factors for depression onset among a community-based sample of adults with asthma.


METHODS
Data were obtained from three telephone interviews conducted at 2-yearly intervals on a longitudinal cohort of adults with asthma (n=439). The Center for Epidemiologic Studies Depression scale (CESD) was used to measure depressive symptoms. Multiple regression analyses tested associations of sociodemographic and health-related variables with depression prevalence (cross-sectional analyses) and incident depression (longitudinal analyses).


RESULTS
15% of subjects were classified as "depressed" (CESD> or =23) at each interview. Individuals depressed at baseline were more likely to drop out (OR=1.76 [95% CI 1.05, 2.96]). Low perceived control of asthma (measured with the Perceived Control of Asthma Questionnaire [PCAQ]) exhibited the most consistent association with depression. Lower PCAQ was cross-sectionally associated with depression (OR=0.51 per 0.5 SD difference in PCAQ [0.35, 0.75]). Onset of depression was noted in 38 individuals. Decrease in perceived control at follow-up was associated with depression onset (OR=7.47 [2.15, 26.01]).


CONCLUSIONS
Low perceived control of asthma predicted depression onset among adults with asthma. This risk factor may respond to self-management education.
Katz
Patricia P
PP
Department of Medicine, University of California, San Francisco, California 94143-0936, USA. patti.katz@ucsf.edu
Morris
Anne
A
Julian
Laura
L
Omachi
Ted
T
Yelin
Edward H
EH
Eisner
Mark D
MD
Blanc
Paul D
PD
D000328:Adult; D001247:Asthenia / Q000150:complications / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D006233:Persons with Disabilities / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012648:Self Care / Q000523:psychology; D011795:Surveys and Questionnaires