title: Are asthma patients at increased risk of clinical depression? A longitudinal cohort study.
abstract: OBJECTIVE
  In this study, we assessed whether adult patients with asthma are more likely to be diagnosed with depression than diabetes patients or "healthy" controls during follow-up in primary care.
  
  
  METHODS
  Data from the Nijmegen Continuous Morbidity Registration were used to assess the risk for a first depression. Patients with asthma were compared with patients with diabetes and with two healthy controls matched on age, gender, socioeconomic status and attending general practice. With Cox proportional hazard analysis, we compared the risk of depression between these groups. These analyses were corrected for relevant covariates including a time-depending variable for multimorbidity. Explorative subgroup analyses were done for age, gender, socioeconomic status and multimorbidity.
  
  
  RESULTS
  Cumulative incidence of depression in asthma patients was 5.2%, in DM patients 4.1% and in control subjects 3.3%. The hazard ratios for a first episode of depression in the asthma patients (n = 795) compared to DM patients (n = 1033) and control subjects after correction for covariates were 1.11 (95% CI 0.60-2.04) and 1.18 (95% CI 0.78-1.79), respectively. Exploratory analyses showed that asthma patients without multimorbidity were at higher risk for a depression compared to reference groups, while asthma patients with multimorbidity were at lower risk for depression.
  
  
  CONCLUSIONS
  Asthma patients were not more likely to be diagnosed with a first depression compared to "healthy" control subjects or diabetes patients. The influence of multimorbidity on depression risk in asthma patients warrants further study.
authors: a Department of Primary and Community Care , Radboud University Medical Center , Nijmegen , The Netherlands.
authors: Lisette
authors: L
authors: van den Bemt
authors: a Department of Primary and Community Care , Radboud University Medical Center , Nijmegen , The Netherlands.
authors: Hilde
authors: H
authors: Luijks
authors: a Department of Primary and Community Care , Radboud University Medical Center , Nijmegen , The Netherlands.
authors: Hans
authors: H
authors: Bor
authors: a Department of Primary and Community Care , Radboud University Medical Center , Nijmegen , The Netherlands.
authors: Evelien
authors: E
authors: Termeer
authors: a Department of Primary and Community Care , Radboud University Medical Center , Nijmegen , The Netherlands.
authors: Peter
authors: P
authors: Lucassen
authors: a Department of Primary and Community Care , Radboud University Medical Center , Nijmegen , The Netherlands.
authors: Tjard
authors: T
authors: Schermer
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012923:Social Class; D055815:Young Adult
keywords: Asthma; cohort study; depression; primary care