title: Mediator effect of depressive symptoms on the association between BMI and asthma control in adults.
abstract: BACKGROUND
  Obesity has been associated with worse asthma control. Depression has also been shown to be disproportionally prevalent among patients with asthma and among patients with obesity. However, no studies have examined the mediating effect of depression on the obesity-asthma relationship. This study examined the extent to which depressive symptoms may mediate the obesity-asthma relationship in an adult sample.
  
  
  METHODS
  A total of 798 patients with physician-diagnosed asthma were recruited from the outpatient asthma clinic at Hôpital du Sacré-Cœur de Montréal. Patients provided demographic and medical history information and completed a battery of questionnaires, including the Beck Depression Inventory (BDI)-II and the Asthma Control Questionnaire (ACQ). BMI was calculated from self-reported height and weight.
  
  
  RESULTS
  Analyses adjusted for age, sex, years of education, cohabitation, and inhaled corticosteroid dose revealed an association between BMI and ACQ (β = 0.017, P = .026), between BMI and BDI-II (β = 0.189, P = .002), and between BDI-II and ACQ (β = 0.044, P < .001). However, when both BDI-II and BMI were entered into the same model, BDI-II (β = 0.044, P < .001) but not BMI (β = 0.009, P = .226) remained significantly associated with ACQ.
  
  
  CONCLUSIONS
  The results indicate that depression and a high BMI are both associated with worse asthma control. However, consistent with our hypotheses, the relationship between BMI and worse asthma control was mediated by depressive symptoms. Future studies should examine the precise role of depressive symptoms in both weight and asthma control.
authors.affiliation: Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal-a University of Montréal affiliated hospital, Montreal, QC, Canada; Research Centre, Hôpital du Sacré-Cœur de Montréal-a University of Montréal affiliated hospital, Montreal, QC, Canada; Department of Psychology, University of Quebec at Montreal, Montreal, QC, Canada.
authors.forename: Maxine
authors.initials: M
authors.lastname: Boudreau
authors.affiliation: Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal-a University of Montréal affiliated hospital, Montreal, QC, Canada; Research Centre, Hôpital du Sacré-Cœur de Montréal-a University of Montréal affiliated hospital, Montreal, QC, Canada; Department of Exercise Science, Concordia University, Montreal, QC, Canada; Research Centre, Montreal Heart Institute-a University of Montréal affiliated hospital, Montreal, QC, Canada.
authors.forename: Simon L
authors.initials: SL
authors.lastname: Bacon
authors.affiliation: Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal-a University of Montréal affiliated hospital, Montreal, QC, Canada; Research Centre, Hôpital du Sacré-Cœur de Montréal-a University of Montréal affiliated hospital, Montreal, QC, Canada; Department of Psychology, University of Quebec at Montreal, Montreal, QC, Canada.
authors.forename: Karine
authors.initials: K
authors.lastname: Ouellet
authors.affiliation: Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal-a University of Montréal affiliated hospital, Montreal, QC, Canada; Research Centre, Hôpital du Sacré-Cœur de Montréal-a University of Montréal affiliated hospital, Montreal, QC, Canada; Department of Psychology, University of Quebec at Montreal, Montreal, QC, Canada.
authors.forename: Ariane
authors.initials: A
authors.lastname: Jacob
authors.affiliation: Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal-a University of Montréal affiliated hospital, Montreal, QC, Canada; Research Centre, Hôpital du Sacré-Cœur de Montréal-a University of Montréal affiliated hospital, Montreal, QC, Canada; Department of Psychology, University of Quebec at Montreal, Montreal, QC, Canada; Research Centre, Montreal Heart Institute-a University of Montréal affiliated hospital, Montreal, QC, Canada. Electronic address: k-lavoie@crhsc.rtss.qc.ca.
authors.forename: Kim L
authors.initials: KL
authors.lastname: Lavoie
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D012650:Self Disclosure; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids