title: Relationship between current psychological symptoms and future risk of asthma outcomes: a 12-month prospective cohort study.
abstract: BACKGROUND
  Subjects with asthma are more susceptible to psychological symptoms, but it is uncertain whether psychological symptoms are linked to future risk of asthma outcomes.
  
  
  OBJECTIVE
  To investigate the relationship between current psychological symptoms and future risk of asthma outcomes.
  
  
  METHODS
  We conducted a prospective cohort study with a 12-month follow-up period of 297 patients with asthma. Psychological symptoms, lung function, asthma control test, and Asthma Quality of Life Questionnaire at baseline were assessed. Asthma outcomes including exacerbations, unplanned visits, emergency visits, hospital admissions, intensive care unit admissions, and length of hospital stays were monitored monthly. The time to the first asthma outcomes was analyzed. Furthermore, the association between psychological symptoms and future risk of asthma outcomes was calculated as adjusted relative risk (RR) using logistic regression models.
  
  
  RESULTS
  The asthma patients were assigned to one of three groups: neither anxiety nor depression symptoms (NAD, n = 102), either anxiety or depression symptoms (A/D, n = 68), or anxiety and depression symptoms (AD, n = 120). Logistic regression models indicated that asthma patients in the AD group, but not the A/D group, had an increased adjusted RR for unplanned visits and emergency visits (RR = 2.33, 95% confidence interval (CI) = [1.50, 3.61]; and RR = 3.13, 95% CI = [1.90, 5.17], respectively). The time to the first asthma outcomes including exacerbations, unplanned visits, and emergency visits was shorter in patients with psychological symptoms than those without (all p < .001).
  
  
  CONCLUSIONS
  Current psychological symptoms, especially anxiety combined with depression, independently predict the future risk of asthma outcomes. Ting Zhou and Lan Wang contributed equally to this study.
authors.affiliation: Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, PR China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.forename: Ting
authors.initials: T
authors.lastname: Zhou
authors.forename: Lan
authors.initials: L
authors.lastname: Wang
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Juan-Juan
authors.initials: JJ
authors.lastname: Fu
authors.forename: Hong-Ping
authors.initials: HP
authors.lastname: Zhang
authors.forename: Yu-Lin
authors.initials: YL
authors.lastname: Ji
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000175:diagnosis* / Q000209:etiology; D001249:Asthma / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology*; D003863:Depression / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005541:Forced Expiratory Volume; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014797:Vital Capacity; D055815:Young Adult