title: Identification of clinically significant psychological distress and psychiatric morbidity by examining quality of life in subjects with occupational asthma.
abstract: BACKGROUND
  The Juniper Asthma Specific Quality of Life Questionnaire (AQLQ(S)) is a questionnaire that allows measurement of disease specific quality of life. We wanted to examine correlations between the (AQLQ(S)) general and different subscale scores and both psychiatric morbidity and levels of psychological distress in individuals with occupational asthma (OA) and to determine if results in the emotional function subscale allow identification of individuals with clinically significant psychological distress or current psychiatric disorders.
  
  
  METHODS
  This was a cross-sectional study of individuals with OA who were assessed during a re-evaluation for permanent disability, after they were no longer exposed to the sensitizing agent. Patients underwent a general sociodemographic and medical history evaluation, a brief psychiatric interview (Primary Care Evaluation of Mental Disorders, PRIME-MD) and completed a battery of questionnaires including the AQLQ(S), the St-Georges Respiratory Questionnaire (SGRQ), and the Psychiatric Symptom Index (PSI).
  
  
  RESULTS
  There was good internal consistency (Cronbach alpha = 0.936 for the AQLQ(S) total score) and construct validity for the AQLQ(S) (Spearman rho = -0.693 for the SGRQ symptom score and rho = -0.650 for the asthma severity score). There were medium to large correlations between the total score of the AQLQ(S) and the SGRQ symptom score (r = -.693), and PSI total (r = -.619) and subscale scores (including depression, r = -.419; anxiety, r = -.664; anger, r = -.367; cognitive disturbances, r = -.419). A cut-off of 5.1 on the AQLQ(S) emotional function subscale (where 0 = high impairment and 7 = no impairment) had the best discriminative value to distinguish individuals with or without clinically significant psychiatric distress according to the PSI, and a cut-off of 4.7 best distinguished individuals with or without a current psychiatric disorder according to the PRIME-MD.
  
  
  CONCLUSIONS
  Impaired quality of life is associated with psychological distress and psychiatric disorders in individuals with OA. Findings suggest that the AQLQ(S) questionnaire may be used to identify patients with potentially clinically significant levels of psychological distress.
authors.affiliation: Division of Chest Medicine, Research Center, Department of Chest Medicine, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin West, Montréal, Québec, H4J 1C5, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Miedinger
authors.forename: Kim L
authors.initials: KL
authors.lastname: Lavoie
authors.forename: Jocelyne
authors.initials: J
authors.lastname: L'Archeveque
authors.forename: Heberto
authors.initials: H
authors.lastname: Ghezzo
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Malo
mesh_terms: D001249:Asthma / Q000523:psychology*; D001985:Bronchial Provocation Tests; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000523:psychology*; D011594:Psychometrics; D011788:Quality of Life; D011792:Quebec; D012372:ROC Curve; D012044:Regression Analysis; D012720:Severity of Illness Index; D013147:Spirometry; D013315:Stress, Psychological / Q000175:diagnosis*; D011795:Surveys and Questionnaires