title: The relationship between asthma and self-reported anxiety in a predominantly healthy adult population.
abstract: BACKGROUND
  Numerous studies involving patients with severe asthma have cited a relation between asthma and anxiety; this relation is responsible for decreased quality of life, increased morbidity, and higher health care usage. However, whether a link between milder asthma and anxiety exists remains unclear.
  
  
  OBJECTIVE
  To determine whether asthma and anxiety share an association in a group of predominantly healthy adults.
  
  
  METHODS
  Adults seen at the Cooper Clinic in Dallas, Texas from March 2000 through January 2013 for preventive medical examinations that included an extensive medical history, including a questionnaire regarding anxiety history, a physician-based physical examination, and laboratory and spirometric testing were used in the analysis. Multiple logistic regressions were used to determine the relation between asthma and anxiety.
  
  
  RESULTS
  The sample consisted of 15,675 patients, of whom 1,403 (9%) had an asthma diagnosis. A sizeable majority of patients with asthma rated their health good or excellent, did not use an inhaler, and had a ratio of forced expiration volume in the first second to forced vital capacity greater than 70%. When controlling for covariates, milder asthma was significantly associated with anxiety (odds ratio 1.435, 95% confidence interval 1.238-1.663, P < .001). Smoking, a variable associated with asthma severity, was significantly associated with anxiety (odds ratio 1.432, 95% confidence interval 1.261-1.626, P < .001), although other variables, such as the ratio of forced expiration volume in the first second to forced vital capacity or use of an inhaled corticosteroid or combined inhaled corticosteroid and a long-acting β agonist, were not significantly associated with anxiety.
  
  
  CONCLUSIONS
  In this cohort of patients with predominantly mild asthma, there was a 43.5% increased risk of anxiety. All patients with asthma should be considered at a higher risk of anxiety and a target population for anxiety screening.
authors.affiliation: Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Elan
authors.initials: E
authors.lastname: Gada
authors.affiliation: Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: David A
authors.initials: DA
authors.lastname: Khan
authors.affiliation: The Cooper Institute, Dallas, Texas.
authors.forename: Laura F
authors.initials: LF
authors.lastname: DeFina
authors.affiliation: Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: sherwood.brown@utsouthwestern.edu.
authors.forename: E Sherwood
authors.initials: ES
authors.lastname: Brown
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology*; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D044382:Population Groups; D012307:Risk Factors; D057566:Self Report; D012907:Smoking; D013147:Spirometry