title: Impact of psychiatric illness upon asthma patients' health care utilization and illness control. Are all psychiatric comorbidities created equal?
abstract: The impact of psychiatric illnesses upon asthma patients' functioning is not well understood. This study examined the impact of psychiatric comorbidity upon illness management in asthma patients using empirically-derived psychiatric comorbidity groups. Participants were a clinic sample of Greek-speaking asthma patients (N = 212) assessed using the Patient Health Questionnaire (PHQ) Somatoform, Depression, Panic Disorder (PD), Other Anxiety Disorder, Eating Disorder (ED) and Alcohol sub-scales. The associations between sub-scales were examined using multiway frequency analysis. The following groups were derived: Somatoform disorder and/or Any Depressive disorder (n = 63), Somatoform disorder and/or Other Anxiety disorder (n = 51), Somatoform disorder and/or Any ED (n = 60), and Any Anxiety group including PD and/or Other Anxiety disorder (n = 24). Across all groups, psychiatric illness was associated with significantly worse asthma control (p < .01). Participants in Any Anxiety group, OR = 4.61, 95% CI [1.90, 11.15], Somatoform and/or Any Depressive disorder, OR = 2.06, 95% CI [1.04, 4.09] and Somatoform and/or Other Anxiety disorder, OR = 2.75, 95% CI [1.35, 5.60] were at higher risk for asthma-related Emergency Room (ER) visits compared to controls. However only Somatoform and/or Any Depressive disorder, OR = 3.67, 95% CI [1.60, 8.72], Somatoform and/or Other Anxiety disorder, OR = 5.50, 95% CI [2.34, 12.74], and Somatoform and/or Any ED, OR = 4.98, 95% CI [2.14, 11.60] group membership were risk factors for asthma-related hospitalizations. Results suggest that while comorbid psychiatric disorders generally negatively impact asthma illness management, different psychiatric comorbidities appear to have disparate effects upon illness management outcomes.
authors.affiliation: a Psychosocial Department , The Institute for Family Health , New York , NY , USA.
authors.forename: Nataliya
authors.initials: N
authors.lastname: Pilipenko
authors.affiliation: b Department of Psychology , University of Cyprus , Nicosia , Cyprus.
authors.forename: Maria
authors.initials: M
authors.lastname: Karekla
authors.affiliation: c Pulmonary Department , Nicosia General Hospital , Nicosia , Cyprus.
authors.forename: Andreas
authors.initials: A
authors.lastname: Georgiou
authors.affiliation: d Ferkauf Graduate School of Psychology , Yeshiva University , New York , NY , USA.|e Department of Pediatrics, Albert Einstein College of Medicine , Yeshiva University , New York , NY , USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Feldman
mesh_terms: D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D001249:Asthma / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003535:Cyprus / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D001068:Feeding and Eating Disorders / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D016584:Panic Disorder / Q000453:epidemiology / Q000523:psychology; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012307:Risk Factors; D013001:Somatoform Disorders / Q000453:epidemiology / Q000523:psychology
keywords: Psychiatric comorbidity; asthma; healthcare utilization; illness management