title: The impact of anxiety and depression on outpatients with asthma.
abstract: BACKGROUND
  Anxiety and depression may frequently affect patients with asthma. However, the findings of several studies are partially conflicting and conducted in selected cohorts.
  
  
  OBJECTIVE
  To investigate the effect of anxiety and depression in a group of outpatients with asthma.
  
  
  METHODS
  This cross-sectional, real-life study included 263 patients (109 males; mean age, 39.2 years) with asthma. Clinical examination, lung function, fractional exhaled nitric oxide measurement, Asthma Control Test (ACT) score, asthma control grade, perception of symptoms by visual analog scale, and Hospital Anxiety and Depression Scale (HADS) questionnaires were evaluated.
  
  
  RESULTS
  Globally, 97 patients (36.9%) had anxiety, and 29 (11%) had depression. Of these patients, 71 had combined anxiety and depression. Anxiety and depression were associated with poor asthma control (P =.007 and .02, respectively). Patients with depression had higher body mass indexes (P =.002). Anxiety and depression were associated with lower ACT scores (P < .001 for both). The scores on the anxiety and depression subscales of HADS were moderately related (r = 0.57).
  
  
  CONCLUSIONS
  The present real-life study indicates that anxiety and depression are common and relevant comorbidities in asthmatic outpatients and are associated with uncontrolled asthma and lower ACT scores. Thus, assessment of comorbid mental disorders should be performed in common practice.
authors.affiliation: Department of Medicine, IRCCS - Azienda Ospedaliera Universitaria San Martino, Genoa, Italy. Electronic address: gio.cip@libero.it.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
authors.affiliation: Health Science Department, University of Genova, Genoa, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Schiavetti
authors.affiliation: Division of Respiratory Disease, Department of Clinical and Biological Sciences, University of Torino, Turin, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Rindone
authors.affiliation: Division of Respiratory Disease, Department of Clinical and Biological Sciences, University of Torino, Turin, Italy.
authors.forename: Fabio L M
authors.initials: FL
authors.lastname: Ricciardolo
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology*; D001249:Asthma / Q000150:complications*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D003866:Depressive Disorder / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D010045:Outpatients; D012720:Severity of Illness Index; D064232:Visual Analog Scale