Depressive symptoms and the incidence of adult-onset asthma in African American women.
BACKGROUND
Some evidence suggests that depression may increase the risk of adult-onset asthma. No data are available for African American women, in whom the prevalence of depression and asthma is high.


OBJECTIVE
To conduct prospective analyses of the relation of depressive symptoms to asthma incidence in the Black Women's Health Study, a prospective cohort of US black women followed since 1995 with mailed biennial questionnaires.


METHODS
Of 31,848 participants followed from 1999 to 2011, 771 reported incident asthma. Depressive symptoms were ascertained on 1999 and 2005 follow-up questionnaires with the Center for Epidemiological Studies-Depression Scale (CES-D). Participants rated the frequency of 20 symptoms. A score was calculated by summing the responses to all questions. Cox regression models were used to derive incidence rate ratios and 95% confidence intervals for 4 categories of the CES-D score in relation to incident asthma, adjusted for body mass index, smoking, and other covariates.


RESULTS
The multivariable incidence rate ratio in the highest category of CES-D score (≥ 33) compared with the lowest (<16) was 2.08 (95% confidence interval 1.58-2.74), with a significant trend (P < .0001). The incidence rate ratio was higher in women who took antidepressants, were current or former smokers, were not obese, and were at least 40 years old, although there were no statistically significant interactions.


CONCLUSIONS
A positive association was observed between CES-D score and the incidence of adult-onset asthma. If the hypothesis is confirmed, depression could contribute substantially to the burden of asthma in adults.
Slone Epidemiology Center at Boston University, Boston, Massachusetts. Electronic address: pcoogan@bu.edu.
Patricia F
PF
Coogan
Slone Epidemiology Center at Boston University, Boston, Massachusetts.
Jeffrey
J
Yu
Boston University School of Medicine, Boston, Massachusetts.
George T
GT
O'Connor
Center for Anxiety and Related Disorders, Boston University, Boston, Massachusetts.
Timothy A
TA
Brown
Slone Epidemiology Center at Boston University, Boston, Massachusetts.
Julie R
JR
Palmer
Slone Epidemiology Center at Boston University, Boston, Massachusetts.
Lynn
L
Rosenberg
D000328:Adult; D001741:Black or African American / Q000523:psychology*; D017668:Age of Onset; D001249:Asthma / Q000453:epidemiology*; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D014481:United States / Q000453:epidemiology