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Anxiety, Depression, and Asthma Control: Changes After Standardized Treatment

2018; Elsevier BV; Volume: 6; Issue: 6 Linguagem: Inglês

10.1016/j.jaip.2018.02.002

2213-2201

J. Sastre, Astrid Crespo‐Lessmann, Antonio Fernández‐Sánchez, Manuel J. Rial, Vicente Plaza, Francisco Callejas Gonzalez, J. Lopez, M. Martínez Riaza, M. Moscardó Orenes, P. Prieto Montaño, M. Torrecillas Toro, Carmen Andreu Balaguer, M. Antón Gironés, C. Baeza Martinez, I. Flores Martín, Purificación González‐Delgado, M. Martos Calahorro, G. Mediero Carrasco, R. Rodríguez Pacheco, Vanessa Tomas, M. Mota Godoy, J. Zapata Yébenes, O. Villarreal Balza De Vallejo, J. Alvarez Fernandez, Teresa Bazús González, G. Castaño De Las Pozas, Carmen Díaz Donado, S. Díaz Angulo, G. Gala Ortiz, B. Requejo Mañana, R. Blanco Gonzalez, E. Gómez Nieves, Javier Torrado, M T Dordal, J. Juanola, Ramón Lleonart Bellfill, Josie Velasco, Ester Pinto Nogués, Marisa Rivera Ortún, P. Rubinstein Aguñin, N. Subira Farre, Joan Valldeperas Combas, Ignacio Ansotegui Zubeldia, G. Bernaola Hortigüela, J. Ciruelos Ayuso, G. González Álvarez, Manuel Peña, Adoración Castro, Paula Losada Llorente, P. Marin Martinez, N Marina Malanda, Fernando Gonzalez, T. Peña Miguel, Manuel Hernández‐Guerra, S. Jimenez Timon, S. Porcel Carreño, Michael Alwakil Olbah, Aurelio Arnedillo Muñoz, J. Chamorro Mohedad, D. Gutierrez Fernandez, Alvaro Camacho, Conde López, Marianela González, Sanchís-Bayarri Bernal, Luis Fernández Pellon, E. Morchon Miguel, Félix Ortiz Portal, A. Suárez Rodríguez, M. Modesto Alapont, Isabela Raducan, M. Salvador Segarra, Pedro Bonilla, P. Mata Calderon, M. Mena Rodriguez, R. Martínez, Magdalena Martín Pérez, M. Morales Villarejo, Marina Blanco–Aparicio, María‐Luisa Joga, L. Fontan Garcia-Boente, Vanesa García-Paz, Francisco Javier González‐Barcala, Ramón Nuñez Orjales, Carlos Rábade, Melissa Diaz, Ana María Moreno‐Fernández, S. Aparicio Español, A. Ruiz San Francisco, Bernardino Alcázar Navarrete, L. Cassini Gomez De Cadiz, Marie Rodriguez, Juan F. López, M. Lara Jiménez, Julián López Caballero, M. Martínez Ceres, R. Mayorgas Costoya, C. Morales García, M. Rojas Vilchez, Angela Ortiz, J. Beitia Mazuecos, Aileen Castro, B. Labeguerie Arenaza, Santiago Mendizábal, I. Perez Sampedro, Lauren Vazquez, Jose Sus, Jordan C. Villa, Diego Ferrer Pargada, J. Herrero Jarque, M. Chacon Patiño, Antonia Fuster Gomila, F. Nicolau Pastrie, J.A. Rodríguez López, Priscilla Martínez, Adolfo Velez Ruiz De Lobera, Francisco Carballada González, C. Perez Carral, A. Veres Racamonde, M. Cervera Del Pino, J. Rozadilla Sacanell, I. Ali García, Y. Anta Mejias, B. Añíbarro Bausela, M. Arroyo Cozar, P. Barranco Sanz, Irina Bobolea, A. Bueso Fernandez, E. De Santiago Delgado, R. Diaz Campos, J. Donado Uña, A. Feliu Vila, M. Gandolfo Cano, Julia García de Pedro, M. Garcimartin Galicia, David González‐de‐Olano, B. Huertas Barbudo, Antolín López-Viña, A. Losada Peña, Gordon M. Martin, A. Montoro De Francisco, R. Moreno Borque, Maria Francesca Moro, M. Ramirez Prieto, M. Reche Frutos, B. Rodriguez Jimenez, Ma. Teresa de Jesús Rodríguez, David Romero Ribate, F. Ruano Perez, J. Ruiz Hornillos, P. Sánchez López, F. Sola Martinez, Javier Subiza Garrido-Lestache, Z. Vasquez Gambasica, C Vila Albelda, Jessica Ramirez, G. Martinez, I. Núñez, Francisco Linde de Luna, Ezequiel Ortega Sáenz de Tejada, Alicia Padilla, R. Rodriguez Martinez, M. Soria Esojo, Rubén Andújar Espinosa, M. Avilés Inglés, Roberto Mora, M. Franco Campos, Maria Arellano, Marta Puebla, B. García Figueroa, S. Fernández, Janny Rivera, Ana Purroy, B. Presedo Garazo, S. Varela Losada, Y. García Villamuza, J. Cumplido Bonny, Roberto Álvarez Sintes, Julia Landin, Alona Paz, María Dolores Corbacho Abelaira, F. Iglesias Rio, Abel Pallarés-Sanmartín, I. Picáns, A. Regueiro Moreira, R. Romera, J. Igea Aznar, Francisco J. Muñoz‐Bellido, Manuel Rodríguez Hernández, R. González Perez, Hemily Izaguirre-Flores, Francisco Javier Álvarez Gutiérrez, Stefan Cimbollek, Virginia de Luque Piñana, Juan Francisco Medina Gallardo, V. Moreno Garcia, Jocelyn Cuevas, Yasmin Crespo, Julio Enríquez, P. Serrano Dominguez, Ò. Sotorra Elias, M. Muñoz Pamplona, M. Jimenez Lara, A Moral, Molly A. Martin, M. Ballester Canelles, E. Burches Baixauli, Pina Serra, Marco Gregori, P. Cordero Rodriguez, M. De Las Marinas Alvarez, Malaika Palacios, D. El-Qutob López, J. Greses Giner, S. Herrera Lara, G. Jorro Martínez, Juan Linana Santafe, Amparo Lloris Bayo, E. Martínez Moragón, I. Molero Sancho, J Montoro Lacomba, Elsa Naval Sendra, L. Navarro Seisdedos, B. Orosa Bertol, A. Robles Iniesta, Juan José Ruiz-Cubillán, F. Sánchez-Toril López, A. Saura Vinuesa, Alejandra Gómez, Julio De Frutos Arribas, E. Macias Fernandez, A. Sanchez Alonso, Cristina Sanz, M. Domínguez Fuentes, M. Garcés Sotillos, N. Segura Arazuri,

Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes

It has been documented that anxiety and depression are prevalent in patients with asthma and are associated with greater frequency of exacerbations, increased use of health care resources, and poor asthma control.To examine the association of asthma diagnosis with symptoms of depression/anxiety and asthma control not only at baseline but also over a 6-month period of specialist supervision.We enrolled 3182 patients with moderate to severe asthma. All were evaluated with spirometry, the Asthma Control Test, and the Hospital Anxiety and Depression Scale at baseline and at 6 months. Treatments were decided by specialists according to published guidelines.At baseline, 24.2% and 12% of the patients were diagnosed with anxiety and depression, respectively, according to the Hospital Anxiety and Depression Scale. After 6 months, anxiety and depression improved, affecting 15.3% and 8.1% of patients, respectively (P < .001); mean FEV1 and asthma control also improved (FEV1 from 81.6% ± 20.9% to 86% ± 20.8%; Asthma Control Test score from 15.8 ± 4.7 to 19.4 ± 4.4; both P < .001). Patients with anxiety and depression used significantly more health care resources and had more exacerbations. A multivariate analysis showed that patients with anxiety, depression, and lower FEV1 (odds ratio, 0.20, 0.34, 0.62, respectively; P < .001) were independently associated with poor asthma control. A multiple linear regression analysis showed that anxiety had a nearly 4-fold greater influence over asthma control than depression (0.326/0.85 = 4.075).Under standardized asthma care and after a specific visit with the specialist, patients present significant improvement in these psychological disorders and exhibit better asthma control and functional parameters.