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Abu Al Karsaneh O, Al Anber A, Al Shboul S, Alrjoub M, Almashaqbeh OI, Alqaisi M, Abuatieh R, Ananzeh SM, Hamad AM, Almomani R, Tommalieh MM. Impact of Anxiety and Depression on the Level of Asthma Control Among Jordanian Adults with Asthma. J Asthma Allergy 2024; 17:463-476. [PMID: 38784527 PMCID: PMC11114137 DOI: 10.2147/jaa.s457875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
Purpose Recent studies imply that psychological factors may actively contribute to the development of asthma. It is generally known that people with asthma frequently suffer from psychological illnesses. This association can make it challenging to reach asthma control. This study aimed to assess the prevalence of depression and anxiety among Jordanian adults with asthma, in addition to the link between asthma control levels and these psychological disorders. Patients and Methods This cross-sectional study included 175 adults with asthma who visited the tertiary asthma clinic in three Jordanian Governmental hospitals. Sociodemographic data was collected directly from the patients who were assessed for their level of depression and anxiety using a self-administered questionnaire, the Hospital Anxiety and Depression Scale (HADS). Also, asthma control was assessed using the Asthma Control Test (ACT). The relation between the different sociodemographic variables and clinical data, particularly depression and anxiety and asthma control level, was assessed. Results Among 175 asthmatic patients, 60.57% had poor disease control, 8% had anxiety alone, 11.43% had depression alone, and 53.14% had anxiety plus depression. Poor asthma control was significantly associated with anxiety and depression (p= 0.044) and low levels of education (p=0.001). Further, a lower level of education was also related to higher levels of anxiety and depression. Conclusion Most of the assessed Jordanian patients with asthma had their disease poorly controlled. Anxiety and depression are common among the studied sample of adults with asthma, and they appear to affect the level of disease control, suggesting the possibility that addressing these psychological conditions could enhance asthma control levels.
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Affiliation(s)
- Ola Abu Al Karsaneh
- Department of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan
| | - Arwa Al Anber
- Department of Pharmacology and Public Health, Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan
| | - Sofian Al Shboul
- Department of Pharmacology and Public Health, Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan
| | - Moath Alrjoub
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | | | - Mohammad Alqaisi
- Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan
| | - Rahaf Abuatieh
- Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan
| | | | - Anas Mousa Hamad
- Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan
| | - Raneem Almomani
- Faculty of Medicine, The Hashemite University, Zarqa, 13133, Jordan
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Wang E, Diaz A, Zhang D, Dimitroyannis R, Kim D, Caballero N, Pinto JM, Roxbury CR. Impact of social determinants of health on access to rhinology care and patient outcomes: A pilot study. Laryngoscope Investig Otolaryngol 2024; 9:e1192. [PMID: 38362189 PMCID: PMC10866601 DOI: 10.1002/lio2.1192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 10/25/2023] [Accepted: 11/15/2023] [Indexed: 02/17/2024] Open
Abstract
Objective This novel pilot study constructs a social deprivation index (SDI) and utilizes an area deprivation index (ADI) to evaluate the link between social determinants of health and rhinology patient experiences. Methods Adult patients undergoing outpatient care of chronic rhinitis and chronic rhinosinusitis at a tertiary academic medical center were recruited to participate in a telephone survey assessing symptoms, social/emotional consequences of disease, and barriers to care on a 5-point Likert scale. Sociodemographic characteristics were utilized to rate SDI on an 8-point scale. ADI was obtained by area code of residence. Ordered logistic regression was used to examine associations between the SDI/ADI and perceptions of rhinology care. Results Fifty patients were included. Individuals with higher SDI scores (i.e., more socially deprived) experienced more severe nasal congestion (p = .007). Furthermore, higher national ADI correlated with increased severity of smell changes (p = .050) and facial pressure (p = .067). No association was seen between either deprivation index and global/psychiatric symptoms. While no correlations were found between higher SDI and difficulties with the costs of prescriptions, rhinologist's visits, or saline, higher SDI was correlated with decreased difficulty with surgery costs (p = .029), and individuals with higher national ADI percentile had increased difficulties obtaining nasal saline (p = .029). Conclusion Worse social deprivation is associated with difficulties obtaining saline rinses and increased severity of nasal/sinus symptoms in an urban, underserved, majority-Black population. These findings suggest social factors affect access to and quality of rhinology care in a complex and nuanced way and highlight the need for a specific SDI to further study social determinants of health in rhinology. Level of Evidence 2c.
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Affiliation(s)
- Esther Wang
- Pritzker School of MedicineUniversity of ChicagoChicagoIllinoisUSA
| | - Ashley Diaz
- Pritzker School of MedicineUniversity of ChicagoChicagoIllinoisUSA
| | - Douglas Zhang
- Pritzker School of MedicineUniversity of ChicagoChicagoIllinoisUSA
| | | | - Daniel Kim
- Pritzker School of MedicineUniversity of ChicagoChicagoIllinoisUSA
| | - Nadieska Caballero
- Department of Surgery, Section of OtolaryngologyUniversity of Chicago MedicineChicagoIllinoisUSA
| | - Jayant M. Pinto
- Department of Surgery, Section of OtolaryngologyUniversity of Chicago MedicineChicagoIllinoisUSA
| | - Christopher R. Roxbury
- Department of Surgery, Section of OtolaryngologyUniversity of Chicago MedicineChicagoIllinoisUSA
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3
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Lv H, Gao Z, Wang Y, Chen S, Liu P, Xie Y, Guan M, Cong J, Xu Y. Metformin Improves Comorbid Depressive Symptoms in Mice with Allergic Rhinitis by Reducing Olfactory Bulb Damage. Neurochem Res 2023; 48:3639-3651. [PMID: 37574530 DOI: 10.1007/s11064-023-04012-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/06/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
Allergic rhinitis (AR) is a widespread disease that is frequently comorbid with depression. However, the mechanisms and treatments for depression in AR remain underexplored. Metformin, a widely used antidiabetic drug, has shown antidepressant effects. The aim of this study was to explore the effects and potential mechanisms of metformin on depression-like behaviors in an AR mouse model. In the present study, mice were sensitized and challenged with ovalbumin (OVA) to induce AR. Results showed that mice with AR exhibited significant depression-like behavior which was attenuated by metformin. In addition, the levels of expression of synaptic plasticity markers (anti-microtubule-associated protein 2, synaptophysin, postsynaptic density protein 95), neurogenesis markers (doublecortin and Ki-67), and brain-derived neurotrophic factor were decreased in the olfactory bulb (OB) of mice with AR, while metformin ameliorated all these alterations and reduced apoptosis in the OB of these mice. Furthermore, it enhanced the phosphorylation of AMP-activated kinase (AMPK) and the levels of ten-eleven translocation 2 (TET2) and 5-hydroxymethylcytosine in the OB. In conclusion, our findings suggest that metformin might be a viable strategy for treating AR-related depression, possibly by modulating neuroplasticity, neurogenesis, apoptosis, and BDNF signaling in the OB via the AMPK/TET2 pathway.
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Affiliation(s)
- Hao Lv
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
| | - Ziang Gao
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
| | - Yunfei Wang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
| | - Siyuan Chen
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
| | - Peiqiang Liu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
| | - Yulie Xie
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
| | - Mengting Guan
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
| | - Jianchao Cong
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China
| | - Yu Xu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China.
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China.
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei, 430060, China.
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan, Hubei, 430060, China.
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Jaun F, Tröster LM, Giezendanne S, Bridevaux PO, Charbonnier F, Clarenbach C, Gianella P, Jochmann A, Kern L, Miedinger D, Pavlov N, Rothe T, Steurer-Stey C, von Garnier C, Leuppi JD. Characteristics of Severe Asthma Patients and Predictors of Asthma Control in the Swiss Severe Asthma Registry. Respiration 2023; 102:863-878. [PMID: 37769646 DOI: 10.1159/000533474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 07/07/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Asthma is a chronic airway disease, affecting over 300 million people worldwide. 5-10% of patients suffer from severe asthma and account for 50% of asthma-related financial burden. Availability of real-life data about the clinical course of severe asthma is insufficient. OBJECTIVES The aims of this study were to characterize patients with severe asthma in Switzerland, enrolled in the Swiss Severe Asthma Registry (SSAR), and evaluate predictors for asthma control. METHOD A descriptive characterisation of 278 patients was performed, who were prospectively enrolled in the registry until January 2022. Socio-demographic variables, comorbidities, diagnostic values, asthma treatment, and healthcare utilisation were evaluated. Groups of controlled and uncontrolled asthma according to the asthma control test were compared. RESULTS Forty-eight percent of patients were female and the mean age was 55.8 years (range 13-87). The mean body mass index (BMI) was 27.4 kg/m2 (±6). 10.8% of patients were current smokers. Allergic comorbidities occurred in 54.3% of patients, followed by chronic rhinosinusitis (46.4%) and nasal polyps (34.1%). According to the ACT score, 54.7% had well controlled, 16.2% partly controlled and 25.9% uncontrolled asthma. The most common inhalation therapy was combined inhaled corticosteroids/long-acting β2-agonists (78.8%). Biologics were administered to 81.7% of patients and 19.1% received oral steroids. The multivariable analysis indicated that treatment with biologics was positively associated with asthma control whereas higher BMI, oral steroids, exacerbations, and COPD were negative predictors for asthma control. CONCLUSION Biologics are associated with improved control in severe asthma. Further studies are required to complete the picture of severe asthma in order to provide improved care for those patients.
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Affiliation(s)
- Fabienne Jaun
- University Center of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland,
- Medical Faculty, University of Basel, Basel, Switzerland,
| | - Lydia Marie Tröster
- University Center of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Stéphanie Giezendanne
- University Center of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
- University Center for Family Medicine, University of Basel, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Pierre-Olivier Bridevaux
- Pneumology Departement, Centre Hospitalier du Valais Romand, Sion, Switzerland
- University Clinic of Pneumology, University Hospital Geneva, Geneva, Switzerland
| | - Florian Charbonnier
- University Clinic of Pneumology, University Hospital Geneva, Geneva, Switzerland
| | | | - Pietro Gianella
- Pneumology Departement, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Anja Jochmann
- Department of Pneumology, University Children Hospital Basel, Basel, Switzerland
| | - Lukas Kern
- Center for Lung Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | | | - Nikolay Pavlov
- Departement of Pulmonary Medicine and Allergology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomas Rothe
- Pneumology Departement, Cantonal Hospital Grisons, Chur, Switzerland
- Pneumology Departement, Hospital Davos AG, Davos, Switzerland
| | - Claudia Steurer-Stey
- mediX Gruppenpraxis, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Christophe von Garnier
- University Clinic of Pneumology, University Hospital Center Vaudoise, Lausanne, Switzerland
| | - Jorg D Leuppi
- University Center of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
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5
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Jackson T, McClatchey K, Chan AHY, Morgan N, Kinley E, Pinnock H. Psychological impact of the COVID-19 pandemic on people with asthma: a co-produced mixed-methods study. Psychol Health 2023:1-21. [PMID: 37695020 DOI: 10.1080/08870446.2023.2256784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 08/18/2023] [Accepted: 09/05/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE When COVID-19 was declared a pandemic there was concern that people living with asthma were at high-risk of poor outcomes. We aimed to explore the psychological impact of living with asthma in the United Kingdom during the pandemic. METHODS AND MEASURES Our mixed methods study, co-designed with patient and public involvement colleagues, included an online survey to detect anxiety/depression/post-traumatic stress disorder (PTSD) and health beliefs; and qualitative interviews. We recruited 849 participants for the survey and interviewed 26 between May and June 2020. Audio-recorded interviews were transcribed verbatim, and analysed thematically. RESULTS The survey identified that 77% of respondents were experiencing symptoms of anxiety, 77% were experiencing symptoms of depression, and PTSD was of concern for 61%. Two-thirds of respondents felt the pandemic had changed how they managed their asthma (n = 568, 66.9%), and over half felt that they had not been given adequate health information about COVID-19 (n = 495, 58.3%). Qualitative interviews identified five themes (1) health communication, (2) interaction with healthcare, (3) COVID-19-related concerns, (4) impact on mental health, and (5) behaviour change. CONCLUSION Psychological distress was prevalent in people with asthma during the early stage of the pandemic. Understanding this may be useful to inform future healthcare/policy planning.
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Affiliation(s)
- Tracy Jackson
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Kirstie McClatchey
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Amy Hai Yan Chan
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Noelle Morgan
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Emma Kinley
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Hilary Pinnock
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
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6
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Zaied RE, Fadason T, O'Sullivan JM. De novo identification of complex traits associated with asthma. Front Immunol 2023; 14:1231492. [PMID: 37680636 PMCID: PMC10480836 DOI: 10.3389/fimmu.2023.1231492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/02/2023] [Indexed: 09/09/2023] Open
Abstract
Introduction Asthma is a heterogeneous inflammatory disease often associated with other complex phenotypes. Identifying asthma-associated diseases and uncovering the molecular mechanisms mediating their interaction can help detangle the heterogeneity of asthma. Network analysis is a powerful approach for untangling such inter-disease relationships. Methods Here, we integrated information on physical contacts between common single nucleotide polymorphisms (SNPs) and gene expression with expression quantitative trait loci (eQTL) data from the lung and whole blood to construct two tissue-specific spatial gene regulatory networks (GRN). We then located the asthma GRN (level 0) within each tissue-specific GRN by identifying the genes that are functionally affected by asthma-associated spatial eQTLs. Curated protein interaction partners were subsequently identified up to four edges or levels away from the asthma GRN. The eQTLs spatially regulating genes on levels 0-4 were queried against the GWAS Catalog to identify the traits enriched (hypergeometric test; FDR ≤ 0.05) in each level. Results We identified 80 and 82 traits significantly enriched in the lung and blood GRNs, respectively. All identified traits were previously reported to be comorbid or associated (positively or negatively) with asthma (e.g., depressive symptoms and lung cancer), except 8 traits whose association with asthma is yet to be confirmed (e.g., reticulocyte count). Our analysis additionally pinpoints the variants and genes that link asthma to the identified asthma-associated traits, a subset of which was replicated in a comorbidity analysis using health records of 26,781 asthma patients in New Zealand. Discussion Our discovery approach identifies enriched traits in the regulatory space proximal to asthma, in the tissue of interest, without a priori selection of the interacting traits. The predictions it makes expand our understanding of possible shared molecular interactions and therapeutic targets for asthma, where no cure is currently available.
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Affiliation(s)
- Roan E Zaied
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Tayaza Fadason
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
- The Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand
| | - Justin M O'Sullivan
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
- The Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand
- Garvan Institute of Medical Research, Sydney, NSW, Australia
- Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore, Singapore
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7
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Sangngam J, Prasopkittikun T, Nookong A, Pacharn P, Chamchan C. Causal relationships among self-management behaviors, symptom control, health-related quality of life and the influencing factors among Thai adolescents with asthma. Int J Nurs Sci 2023; 10:309-317. [PMID: 37545770 PMCID: PMC10401355 DOI: 10.1016/j.ijnss.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/17/2023] [Accepted: 06/15/2023] [Indexed: 08/08/2023] Open
Abstract
Objective To examine causal relationships among asthma self-management behaviors, asthma symptom control, health-related quality of life and the influencing factors among Thai adolescents. Methods A cross-sectional study was conducted using convenience sampling. A total of 240 adolescent-caregiver dyads from three tertiary hospitals in Bangkok, Thailand was ultimately included. Interviews and self-administered questionnaires assessing health-related quality of life, asthma symptom control, asthma self-management behaviors, health literacy, depression, comorbidities, family support, peer support, home environmental management, and relationships with health care providers were administered between November 2020 and July 2021. A hypothesized model based on the revised self- and family-management framework was proposed. Data were analyzed using descriptive statistics and path analysis. Results It was shown that the proposed model was a good fit for the empirical data and accounted for 67.2% of the variance in health-related quality of life. Depression and asthma symptom control directly affected quality of life (β = -0.132, P < 0.05; and β = 0.740, P < 0.05, respectively), while asthma self-management behaviors did not. Both depression and asthma self-management behaviors had indirect effects on the quality of life through asthma symptom control (β = -0.382, P < 0.05; and β = 0.225, P < 0.05, respectively). Health literacy (β = 0.343, P < 0.05), family support (β = 0.167, P < 0.05), peer support (β = 0.163, P < 0.05), and relationships with health care providers (β = 0.181, P < 0.05) also showed direct effects on asthma self-management behaviors. Conclusion The findings confirmed the causal relationships among asthma symptom control, self-management behaviors, depression and health-related quality of life. Health literacy, support from family and peers, and relationships with health care providers were also found to influence asthma self-management behaviors. To achieve effective asthma control and good quality of life, a nursing intervention promoting asthma self-management for Thai adolescents should be developed. Early detection and intervention of depressive symptoms are also suggested.
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Affiliation(s)
| | | | - Apawan Nookong
- Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Punchama Pacharn
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chalermpol Chamchan
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
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8
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Theodoro EE, Rocha DGD, Bertolino JR, Guinossi RM, Burch MO, Mingotti CFB, Assunção RP, Ponte EV. Evaluating the effect of antidepressants on the relationship between depression and asthma. Respir Med 2023; 207:107099. [PMID: 36584793 DOI: 10.1016/j.rmed.2022.107099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 12/16/2022] [Accepted: 12/27/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND It is unclear if depression is associated with impaired lung function in subjects with asthma, while few studies evaluated the effect of antidepressants on the relationship between depression and asthma. We designed this study to investigate if subjects with concomitant asthma and depression not taking antidepressants have worse asthma outcomes compared to asthmatic subjects without depression, and to evaluate whether antidepressants modify this association. METHODS This is a cross-sectional study. We included non-smokers with asthma, 18 years old or above. Study subjects attended an appointment with a chest physician, answered study questionnaires and underwent a spirometry test. We performed crude and adjusted binary logistic regression analyses. RESULTS We enrolled 309 subjects with asthma, of whom 48 with depression taking antidepressants, 52 with depression not taking antidepressants, and 209 without depression (control group). Asthmatic subjects with depression who had not used antidepressants before enrollment were more likely to have uncontrolled symptoms of asthma [adjusted OR 3.10, 95CI (1.56-6.15)] and airway obstruction [adjusted OR 2.41, 95CI (1.24-4.69)] compared to the control group. Subjects who had used antidepressants had higher odds of uncontrolled symptoms of asthma [adjusted OR 3.02, 95CI (1,50-6.07)], but similar odds of airway obstruction [adjusted OR 1.24, 95CI (0.87-1.77)] compared to the control group. CONCLUSIONS Non-treated depression is associated with airway obstruction in subjects with asthma, but antidepressants modify this association. Thus, we recommend regular screening of depression in subjects with asthma, and prescription of antidepressants whenever depression symptoms justify pharmacological therapy.
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9
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Honkamäki J, Ilmarinen P, Hisinger-Mölkänen H, Tuomisto LE, Andersén H, Huhtala H, Sovijärvi A, Lindqvist A, Backman H, Nwaru BI, Rönmark E, Lehtimäki L, Pallasaho P, Piirilä P, Kankaanranta H. Nonrespiratory Diseases in Adults Without and With Asthma by Age at Asthma Diagnosis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:555-563.e4. [PMID: 36441098 DOI: 10.1016/j.jaip.2022.10.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 10/16/2022] [Accepted: 10/19/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chronic nonrespiratory diseases are seemingly more prevalent in subjects with than without asthma, and asthma seems to differentiate by age of onset. However, studies with comparison of nonrespiratory diseases in subjects with and without asthma, considering asthma age of onset, are scarce. OBJECTIVE To compare the quantity and type of chronic nonrespiratory diseases in adults with and without asthma considering age at asthma diagnosis. METHODS In 2016, a FinEsS questionnaire was sent to 16,000 20- to 69-year-old adults randomly selected in Helsinki and Western Finland populations. Physician-diagnosed asthma was categorized to early (0-11), intermediate (12-39), and late-diagnosed (40-69 years). RESULTS A total of 8199 (51.5%) responded, and 842 (10.3%) reported asthma and age at diagnosis. In age and sex-adjusted binary logistic regression model, the most represented nonrespiratory disease was treated gastroesophageal reflux disease in early-diagnosed (odds ratio, 1.93; 95% CI, 1.17-3.19; P = .011) and osteoporosis in both intermediate-diagnosed (odds ratio, 3.45; 95% CI, 2.01-5.91; P < .001) and late-diagnosed asthma (odds ratio, 2.91; 95% CI, 1.77-4.79; P < .001), compared with subjects without asthma. In addition, gastroesophageal reflux disease, depression, sleep apnea, painful condition, and obesity were significantly more common in intermediate- and late-diagnosed asthma compared with without asthma, and similarly anxiety or panic disorder in intermediate-diagnosed and hypertension, severe cardiovascular disease, arrhythmia, and diabetes in late-diagnosed asthma. In age-adjusted analyses, having 3 or more nonrespiratory diseases was more common in intermediate (12.1%) and late-diagnosed asthma (36.2%) versus without asthma (10.4%) (both P < .001). CONCLUSIONS Nonrespiratory diseases were more common in adults with asthma than in adults without asthma. The type of nonrespiratory diseases differed, and their frequency increased by increasing age at asthma diagnosis.
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Affiliation(s)
- Jasmin Honkamäki
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Pinja Ilmarinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | | | - Leena E Tuomisto
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Heidi Andersén
- Karolinska University Hospital, Thoracic Oncology Unit, Tema Cancer, Stockholm, Sweden
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Anssi Sovijärvi
- Unit of Clinical Physiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Ari Lindqvist
- Research Unit of Pulmonary Diseases, Helsinki University Hospital, University of Helsinki and Clinical Research Institute HUCH Ltd, Helsinki, Finland
| | - Helena Backman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN Unit, Umeå University, Umeå, Sweden
| | - Bright I Nwaru
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN Unit, Umeå University, Umeå, Sweden
| | - Lauri Lehtimäki
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Allergy Centre, Tampere University Hospital, Tampere, Finland
| | | | - Päivi Piirilä
- Unit of Clinical Physiology, HUS Medical Imaging Center, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Hannu Kankaanranta
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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10
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Sanad EA, El-Shinnawy HAEH, Hebah HA, Farrag DA, Soliman ERA, Abdelgawad MA. Effect of intra-dialytic physical exercise on depression in prevalent hemodialysis patients. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00560-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
Depression is associated with morbidity, death, diminished quality of life, decreased longevity, and even suicidal ideation in hemodialysis patients. Intra-dialytic exercise is considered as integral component of the clinical care management of hemodialysis patients as it improves hemodialysis effectiveness, reducing systemic inflammation, increasing exercise tolerance, decreasing depression and improving quality of life. The objective of this study was to assess the effect of intra-dialytic physical exercise on depression and physical activity in prevalent hemodialysis patients. This prospective cohort research comprised 50 hemodialysis patients maintained on regular hemodialysis 3 times/week with duration since starting dialysis (1–5 years), not practicing any previous physical activity, suffering from depressive symptoms, not maintained on antidepressants and separated into two groups: group I underwent intra-dialytic exercise for 3 months and group II was matched in age and gender but did not undertake any exercise.
Results
Hamilton depression rating scale was significantly decreased in group I after completing the exercise program compared to baseline (P = 0.000), while there was no significant change in group II. Serum tumor necrosis factor alpha significantly decreased in group I compared to baseline (P = 0.000), while there was no significant change in group II. A positive correlation was found between serum tumor necrosis factor alpha and Hamilton depression rating scale (r = 0.676), (P = 0.000). Physical activity tests; 6-min walk test, rapid assessment of physical activity and peak volume of oxygen consumption were significantly improved in group I compared to baseline (P = 0.000), while there was no statistically significant difference in group II. Serum phosphorus and parathyroid hormone levels were significantly decreased in group I compared to baseline (P < 0.01), while urea reduction ratio was significantly increased in group I compared to baseline (P = 0.000), but there was no significant change in group II.
Conclusions
Intra-dialysis exercise can improve depression and physical performance in hemodialysis patients. As positive correlation was found between serum tumor necrosis factor alpha and Hamilton depression rating scale, so tumor necrosis factor alpha may be considered as marker of depression in hemodialysis patients. Intra-dialytic exercise can improve dialysis efficacy by improving urea reduction ratio.
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11
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Lin WJ, Chang YL, Weng LC, Tsai FC, Huang HC, Yeh SL, Chen KH. Post-Discharge Depression Status for Survivors of Extracorporeal Membrane Oxygenation (ECMO): Comparison of Veno-Venous ECMO and Veno-Arterial ECMO. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063333. [PMID: 35329031 PMCID: PMC8954682 DOI: 10.3390/ijerph19063333] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/03/2022] [Accepted: 03/09/2022] [Indexed: 12/16/2022]
Abstract
Extracorporeal membrane oxygenation (ECMO) is one of the common invasive treatments for the care of critically ill patients with heart failure, respiratory failure, or both. There are two modes of ECMO, namely, veno-venous (VV) and veno-arterial (VA), which have different indications, survival rates, and incidences of complications. This study’s aim was to examine whether depression status differed between patients who had received VV-ECMO or VA-ECMO and had been discharged from the hospital. This was a descriptive, cross-sectional, and correlational study of patients who had been discharged from the hospital at least one month after receiving ECMO at a medical center in northern Taiwan from June 2006 to June 2020 (N = 142). Participants were recruited via convenience and quota sampling. Data were collected in the cardiovascular outpatient department between October 2015–October 2016 (n = 52) and September 2019–August 2020 (n = 90). Participants completed the Hospital Anxiety and Depression Scale–Depression (HADS-D) as a measure of depression status. Post-discharge depression scores for patients who received VV-ECMO (n = 67) was significantly higher (p = 0.018) compared with participants who received VA-ECMO (n = 75). In addition, the mode of ECMO was a predictor of post-discharge depression (p = 0.008) for participants who received VV-ECMO. This study concluded that patients who received VV-ECMO may require greater mental health support. Healthcare professionals should establish a psychological clinical care pathway evaluated by multiple healthcare professionals.
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Affiliation(s)
- Wan-Jung Lin
- Department of Nursing, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 100, Taiwan;
| | - Yu-Ling Chang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan; (Y.-L.C.); (L.-C.W.)
- Department of Nursing, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City 333, Taiwan
| | - Li-Chueh Weng
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan; (Y.-L.C.); (L.-C.W.)
- Department of General Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City 333, Taiwan
| | - Feng-Chun Tsai
- Department of Cardiovascular Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City 333, Taiwan; (F.-C.T.); (H.-C.H.)
- College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan
| | - Huei-Chiun Huang
- Department of Cardiovascular Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City 333, Taiwan; (F.-C.T.); (H.-C.H.)
| | - Shu-Ling Yeh
- Department of Nursing, Chang Gung Memorial Hospital, Taoyuan Branch, Taoyuan City 333, Taiwan;
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City 333, Taiwan
| | - Kang-Hua Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan; (Y.-L.C.); (L.-C.W.)
- Department of Nursing, Chang Gung Memorial Hospital, Taoyuan Branch, Taoyuan City 333, Taiwan;
- Correspondence: ; Tel.: +886-3-211-8800 (ext. 5211)
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12
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Karlsson Sundbaum J, Konradsen JR, Vanfleteren LEGW, Axelsson Fisk S, Pedroletti C, Sjöö Y, Syk J, Sterner T, Lindberg A, Tunsäter A, Nyberg F, Ekberg-Jansson A, Stridsman C. Uncontrolled asthma predicts severe COVID-19: a report from the Swedish National Airway Register. Ther Adv Respir Dis 2022; 16:17534666221091183. [PMID: 35430944 PMCID: PMC9019327 DOI: 10.1177/17534666221091183] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Severe asthma increases the risk of severe COVID-19 outcomes such as hospitalization and death. However, more studies are needed to understand the association between asthma and severe COVID-19. Methods: A cohort of 150,430 adult asthma patients were identified in the Swedish National Airway Register (SNAR) from 2013 to December 2020. Data on body mass index, smoking habits, lung function, and asthma control test (ACT) were obtained from SNAR, and uncontrolled asthma was defined as ACT ⩽19. Patients with severe COVID-19 were identified following hospitalization or in death certificates based on ICD-10 codes U07.1 and U07.2. The Swedish Prescribed Drug register was used to identify comorbidities and data from Statistics Sweden for educational level. Multivariate logistic regression analyses were used to estimate associations with severe COVID-19. Results: Severe COVID-19 was identified in 1067 patients (0.7%). Older age (OR = 1.04, 95% CI = 1.03–1.04), male sex (1.42, 1.25–1.61), overweight (1.56, 1.27–1.91), obesity (2.12, 1.73–2.60), high-dose inhaled corticosteroids in combination with long-acting β-agonists (1.40, 1.22–1.60), dispensed oral corticosteroids ⩾2 (1.48, 1.25–1.75), uncontrolled asthma (1.64, 1.35–2.00), cardiovascular disease (1.20, 1.03–1.40), depression (1.47, 1.28–1.68), and diabetes (1.52, 1.29–1.78) were associated with severe COVID-19, while current smoking was inversely associated (0.63, 0.47–0.85). When comparing patients who died from COVID-19 with those discharged alive from hospital until 31 December 2020, older age, male sex, and current smoking were associated with COVID-19 death. Conclusion: Patients with uncontrolled asthma and high disease burden, including increased asthma medication intensity, should be identified as risk patients for severe COVID-19. Furthermore, current smoking is strongly associated with COVID-19 death in asthma.
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Affiliation(s)
| | - Jon R Konradsen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Lowie E G W Vanfleteren
- COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sten Axelsson Fisk
- Department of Clinical Sciences Lund, Obstetrics and Gynaecology, Lund University and Ystad Hospital, Lund, Sweden
| | | | - Yvonne Sjöö
- The Swedish National Airway Register, Gothenburg, Sweden
| | - Jörgen Syk
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Academic Primary Health Care Centre, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Therese Sterner
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Anne Lindberg
- Department of Public Health and Clinical Medicine, Umeå University, Devision of Medicine/ The OLIN- unit, Umeå University, Umeå, Sweden
| | - Alf Tunsäter
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ann Ekberg-Jansson
- COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Caroline Stridsman
- Department of Public Health and Clinical Medicine, Umeå University, Devision of Medicine/ The OLIN- unit, Umeå University, Umeå, Sweden
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13
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Yang ZC, Wang LX, Yu Y, Lin HY, Shih LC. Increased Risk of Postpartum Depression in Women With Allergic Rhinitis During Pregnancy: A Population-Based Case-Control Study. Ann Otol Rhinol Laryngol 2021; 131:1137-1143. [PMID: 34779274 DOI: 10.1177/00034894211058135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Allergic rhinitis (AR) is associated with increased risk of major depression in the general population, however, no previous study has evaluated its role among pregnant women. We aimed to investigate the potential impact of AR during pregnancy on the development of postpartum depression (PPD). METHODS This is a population-based case-control study. Data were retrieved from the National Health Insurance Research Database (NHIRD). Medical records of a total of 199 470 deliveries during 2000 and 2010 were identified. Among which, 1416 women with PPD within 12 months after delivery were classified as the case group, while 198 054 women without PPD after delivery formed the control group. Univariate and multivariate regression analyses were conducted to determine the associations between AR during pregnancies and other study variables with PPD. RESULTS AR during pregnancy was found in 9.53% women who developed PPD and 5.44% in women without PPD. After adjusting for age at delivery, income level, various pregnancy and delivery-related conditions, asthma, atopic dermatitis and other medical comorbidities in the multivariate analysis, AR was significantly associated with increased odds of PPD (aOR: 1.498, 95% CI: 1.222-1.836). CONCLUSION AR during pregnancy was independently and significantly associated with an approximately 50% increased risk of PPD among women giving birth. Closely monitoring of AR is warranted in the future in order to optimize mother and child outcomes after delivery.
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Affiliation(s)
- Zhi-Chao Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Li-Xin Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yang Yu
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Huan-Yu Lin
- Department of Otorhinolaryngology, China Medical University Hospital, Taichung
| | - Liang-Chun Shih
- Department of Otorhinolaryngology, China Medical University Hospital, Taichung
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14
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Kim O, Kim B, Jeong H, Lee J, Jung H. Sleep, Fatigue, and Depressive Symptoms among Female Nurses with Allergic Rhinitis. Healthcare (Basel) 2021; 9:healthcare9101328. [PMID: 34683008 PMCID: PMC8544519 DOI: 10.3390/healthcare9101328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/21/2021] [Accepted: 10/01/2021] [Indexed: 11/16/2022] Open
Abstract
Allergic rhinitis (AR) is a common chronic disease that negatively affects physical and mental health. The purpose of this study was to determine the effects of allergic rhinitis on sleep, fatigue, and depressive symptoms among Korean female nurses. This was a cross-sectional study conducted using data from the Korea Nurses' Health Study (KNHS), and a total of 8645 female nurses was selected for the final analysis. The demographic characteristics, Body Mass Index, alcohol consumption, shift work, comorbidities (atopic dermatitis and asthma), self-rated health, sleep disturbance (Jenkins Sleep Questionnaire), fatigue (Chalder Fatigue Scale), and depressive symptoms (Perceived Health Questionnaire-9) were collected. The data were analyzed using chi-square tests, t-tests, and hierarchical multiple regression analyses. Participants with allergic rhinitis had significantly greater sleep disturbance, fatigue, and depressive symptoms than those without allergic rhinitis, and allergic rhinitis was a significant factor influencing sleep disturbance and fatigue among the participants after controlling for confounding variables. Therefore, it is imperative to develop effective interventions to manage allergic rhinitis symptoms and improve sleep and fatigue in affected nurses.
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Affiliation(s)
- Oksoo Kim
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea; (O.K.); (B.K.); (H.J.); (J.L.)
| | - Bohye Kim
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea; (O.K.); (B.K.); (H.J.); (J.L.)
| | - Hyunseon Jeong
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea; (O.K.); (B.K.); (H.J.); (J.L.)
| | - Jisun Lee
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea; (O.K.); (B.K.); (H.J.); (J.L.)
| | - Heeja Jung
- College of Nursing, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea
- Correspondence: ; Tel.: +82-42-600-8581
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15
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Lauden A, Geishin A, Merzon E, Korobeinikov A, Green I, Golan-Cohen A, Vinker S, Manor I, Weizman A, Magen E. Higher rates of allergies, autoimmune diseases and low-grade inflammation markers in treatment-resistant major depression. Brain Behav Immun Health 2021; 16:100313. [PMID: 34589804 PMCID: PMC8474658 DOI: 10.1016/j.bbih.2021.100313] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/17/2021] [Accepted: 07/28/2021] [Indexed: 12/28/2022] Open
Abstract
Only 30% of patients with major depressive disorder (MDD) reach full recovery or remission. Treatment-resistant depression (TRD) is MDD that does not respond to adequate treatment attempts with at least two antidepressants. TRD is associated more with immune activation than with treatment responsive depression. The current retrospective population-based cross-sectional study, utilizing data from a large nation-wide health maintenance organization in Israel which provides services to estimated 725,000 members, aimed to assess the clinical signs and laboratory markers of autoimmune comorbidity and low-grade inflammation, in patients with TRD. Included were participants aged 18-70 years, diagnosed twice within one year with ICD-9-CM MDD and two control groups, MDD responders (MDD-r) consisting of people with MDD and no TRD and a non-MDD group that included people with no MDD or TRD. The case (570 subjects in TRD group) to control ratio in both control groups (2850 subjects in MDD-r and 2850 subjects in non-MDD control group) was 1:5. Compared to MDD-r, the overall proportion of allergic diseases was higher among the TRD than among the MDD-r [OR 1.52 (1.19-1.94); p < 0.001]. Any systemic autoimmune disease was associated with increased likelihood of MDD-r [OR 1.52 (1.04-2.24); p = 0.03] or TRD [OR 2.22 (1.30-3.78); p = 0.003]. Higher rates of positive (>1:80) antinuclear antibodies [33 (5.79%)] were found among the TRD than among the MDD-r [98 (3.44%); p = 0.011). More allergy and autoimmune comorbidities and presence of low-grade inflammation biomarkers, were found mainly in TRD.
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Affiliation(s)
- Ari Lauden
- Leumit Health Services, Israel
- Psychiatric Division, Faculty of Health Sciences, Ben Gurion University of the Negev, Israel
| | | | - Eugene Merzon
- Leumit Health Services, Israel
- Department of Family Medicine, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Ilan Green
- Leumit Health Services, Israel
- Department of Family Medicine, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Avivit Golan-Cohen
- Leumit Health Services, Israel
- Psychiatric Division, Faculty of Health Sciences, Ben Gurion University of the Negev, Israel
| | - Shlomo Vinker
- Leumit Health Services, Israel
- Department of Family Medicine, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Iris Manor
- ADHD Outpatient Clinic, Geha Mental Health Center, Petah Tikva, Israel and Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abraham Weizman
- Research Unit, Geha Mental Health Center, Petah Tikva, Israel and Laboratory of Molecular Psychiatry, Felsenstein Medical Research Center, Petah Tikva, Israel and Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eli Magen
- Leumit Health Services, Israel
- Clinical Immunology and Allergy Division, Medicine C Department, Barzilai University Medical Center, Ben Gurion University of the Negev, Israel
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16
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Feldman JM, Becker J, Arora A, DeLeon J, Torres-Hernandez T, Greenfield N, Wiviott A, Jariwala S, Shim C, Federman AD, Wisnivesky JP. Depressive Symptoms and Overperception of Airflow Obstruction in Older Adults With Asthma. Psychosom Med 2021; 83:787-794. [PMID: 33938504 PMCID: PMC8419010 DOI: 10.1097/psy.0000000000000951] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Older adults are at increased risk for depression and poor asthma outcomes. We examined whether depressive symptoms are associated with overperception of airflow obstruction and a pattern of worse asthma control, but not pulmonary function. METHODS We recruited a cohort of adults with asthma 60 years and older in East Harlem and the Bronx, New York. Baseline measures included the Geriatric Depression Scale, Asthma Control Questionnaire, and Mini Asthma Quality of Life Questionnaire. Spirometry was conducted at baseline to assess pulmonary function. Perception of airflow obstruction was assessed for 6 weeks following baseline by participants entering estimates of peak expiratory flow (PEF) into a programmable peak flow meter followed by PEF blows. Participants were blinded to actual PEF values. The percentage of time that participants were in the overperception zone was calculated as an average. RESULTS Among the 334 participants (51% Hispanic, 25% Black), depressive symptoms were associated with overperception of airflow obstruction (β = 0.14, p = .029), worse self-reported asthma control (β = 0.17, p = .003), and lower asthma-related quality of life (β = -0.33, p < .001), but not with lung function (β = -0.01, p = .82). Overperception was also associated with worse self-reported asthma control (β = 0.14, p = .021), but not lung function (β = -0.05, p = .41). CONCLUSIONS Depressive symptoms were associated with greater perceived impairment from asthma, but not pulmonary function. Overperception of asthma symptoms may play a key role in the relationship between depression and asthma outcomes in older adults.
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Affiliation(s)
- Jonathan M Feldman
- From the Ferkauf Graduate School of Psychology (Feldman, Greenfield, Wiviott), Yeshiva University; Division of Academic General Pediatrics, Department of Pediatrics (Feldman, DeLeon, Torres-Hernandez), Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx; Division of General Internal Medicine (Becker, Arora, Federman, Wisnivesky), Icahn School of Medicine at Mount Sinai, New York; Division of Allergy/Immunology, Department of Medicine (Jariwala), Albert Einstein College of Medicine/Montefiore Medical Center; Division of Pulmonary Medicine, Department of Medicine (Shim), Jacobi Medical Center/Albert Einstein College of Medicine, Bronx; and Division of Pulmonary, Critical Care and Sleep Medicine (Wisnivesky), Icahn School of Medicine at Mount Sinai, New York, New York
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17
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Rodrigues J, Franco-Pego F, Sousa-Pinto B, Bousquet J, Raemdonck K, Vaz R. Anxiety and depression risk in patients with allergic rhinitis: a systematic review and meta-analysis. Rhinology 2021; 59:360-373. [PMID: 34254060 DOI: 10.4193/rhin21.087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Allergic diseases appear to be associated with mood disorders. However, particularly regarding allergic rhinitis (AR), such association has not been adequately systematically reviewed. Therefore, we conducted a systematic review and meta-analysis to quantify the association between AR and depression and anxiety. METHODOLOGY We performed an electronic search of PubMed, Web of Science and Scopus for observational studies assessing the association between AR and depression and anxiety. Such association was quantified by means of random-effects meta-analysis, with estimation of pooled odds ratio (OR). Sources of heterogeneity were explored by subgroup analysis. RESULTS We included a total of 24 primary studies, of which 23 assessed depression and 11 assessed anxiety. Of these, 12 studies presented OR from multivariable regression models and were included in our meta-analysis. AR was associated with higher odds of depression and anxiety. CONCLUSIONS AR appears to be associated with high risk of depression and anxiety. While our results point to the importance of mental comorbidities among patients with AR, longitudinal studies are needed adopting uniform definitions and presenting results stratified by AR severity.
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Affiliation(s)
- J Rodrigues
- Otorhinolaryngology Department, Centro Hospitalar Universitario de S. Joao, EPE, Porto, Portugal; Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS â€" Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - F Franco-Pego
- CINTESIS "Center for Health Technology and Services Research, University of Porto, Porto, Portugal; MEDCIDS" Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal
| | - B Sousa-Pinto
- CINTESIS "Center for Health Technology and Services Research, University of Porto, Porto, Portugal; MEDCIDS" Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal
| | - J Bousquet
- Charite, Universitatsmedizin Berlin, Humboldt-Universitat zu Berlin, Berlin, Germany; Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin Institute of Health, Berlin, Germany; MACVIA-France, Montpellier, France
| | - K Raemdonck
- Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS" Center for Health Technology and Services Research, University of Porto, Porto, Portugal; CESPU â€" Institute of Research and Advanced Training in Health Sciences and Technologies (IINFACTS), Gandra, Portugal
| | - R Vaz
- Otorhinolaryngology Department, Centro Hospitalar Universitario de S. Joao, EPE, Porto, Portugal; Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS â€" Center for Health Technology and Services Research, University of Porto, Porto, Portugal
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18
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Rhinitis Phenotypes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 8:1492-1503. [PMID: 32389274 DOI: 10.1016/j.jaip.2020.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/11/2020] [Accepted: 02/11/2020] [Indexed: 02/08/2023]
Abstract
Rhinitis is an umbrella term of a group of upper airway diseases with nasal symptoms and signs with different etiologies and various clinical features or traits. It can be classified into different "phenotypes," based on these observable traits. A proper differential diagnosis is necessary to adequately manage the disease. The objective of this review is to clarify the concept of rhinitis phenotypes while analyzing the clinical features and/or traits of each in order to determine a proper differential diagnosis and appropriate treatment.
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19
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Xie X, Xu D, Zhuang L, Liu H, Tan S, Lu Y, Su M, Chen J, Pan H, Lu L, Xu Y, Liao M, Xu Z, He J. Sanfu herbal patch applied at acupoints in patients with bronchial asthma: study protocol for a randomized controlled trial. Trials 2020; 21:684. [PMID: 32727619 PMCID: PMC7389380 DOI: 10.1186/s13063-020-04604-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 07/12/2020] [Indexed: 11/29/2022] Open
Abstract
Background Bronchial asthma is one of the most common inflammatory airway disorders. As one of the main non-drug therapies, the Sanfu herbal patch (SHP) has been widely used to treat bronchial asthma, although the evidence for its efficacy and associated mechanism are inconclusive. The objective of this trial is to clarify the clinical efficacy and safety of the SHP in the treatment of bronchial asthma in the chronic persistent or clinical remission stage and to provide high-quality data for further research. Methods We propose a multicentre, double-blinded, parallel, randomized, placebo-controlled clinical trial involving 4 study hospitals in China. A total of 72 eligible participants will be randomized into an SHP group and a placebo group. They will receive an SHP for 3 treatment sessions. The primary outcome will be changes in forced expiratory volume in 1 s after 3 treatment sessions. Secondary outcomes will include the following: (1) the Asthma Quality of Life Questionnaire, Asthma Control Test, and Asthma Long-term Follow-up Scale; (2) levels of Metallothionein-2 and Transgelin-2 in blood and urine; and (3) levels of IL-5, IL-13, IL-23, IL-25, and thymic stromal lymphopoietin in blood. Analysis of the data will be performed at baseline, at the end of the 2nd and 3rd treatment sessions, and at the 24-week follow-up. The safety of the SHP will be evaluated at each treatment session. Discussion The aims of this trial are to determine whether the SHP is more effective than placebo in the treatment of patients with bronchial asthma, as well as whether the SHP works by reducing airway inflammation and reversing bronchoconstriction. Trial registration Chinese Clinical Trial Registry (http://www.chictr.org.cn), ChiCTR1900024616. Registered on 19 July 2019.
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Affiliation(s)
- Xiaoyan Xie
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, China.,Department of Rehabilitation Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Danghan Xu
- Department of Rehabilitation Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Lixing Zhuang
- Department of Rehabilitation Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Hui Liu
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Sui Tan
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Yanqing Lu
- The Fifth Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510095, China
| | - Meiyi Su
- The Fifth Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510095, China
| | - Jie Chen
- Guangdong Second Provincial General Hospital, Guangzhou, 510317, China
| | - Haihua Pan
- Pingshan District Peoples' Hospital of Shenzhen, Shenzhen, 518118, China
| | - Lu Lu
- Lingnan Medical Research Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Yiming Xu
- Guangzhou Medical University, Guangzhou, 515000, China
| | - Muxi Liao
- Department of Rehabilitation Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Zhanqiong Xu
- Department of Rehabilitation Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China
| | - Jun He
- Department of Rehabilitation Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
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20
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Kim JY, Han YJ, Lee JS, Lee JH, Jo SH, Kim SH. Evaluation of a possible association between allergic rhinitis and depression, suicidal ideation, and suicide attempts among adolescents based on a nationwide cross-sectional study. Int J Pediatr Otorhinolaryngol 2020; 134:110070. [PMID: 32387708 DOI: 10.1016/j.ijporl.2020.110070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/23/2020] [Accepted: 04/23/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE We assessed associated factors for depression and suicidality among adolescents with allergic rhinitis (AR) by analyzing data from annual Korea Youth Risk Behavior Web-based Surveys (KYRBSs) completed from 2007 to 2017. METHODS Data from the KYRBS were obtained from a stratified, multistage, clustered sample. Using self-reported questionnaires, students provided yes-or-no answers to questions addressing their doctor-diagnosed AR and self-experienced depression, suicidal ideation and suicide attempts. Associated factors for depression and suicidality were identified by logistic regression models after controlling for potential confounding factors. A total of 818,684 adolescents were targeted, and 788,411 adolescents completed the survey. RESULTS An AR diagnosis was reported in 30.8% of respondents. Among respondents with AR, 34.5%, 18.4%, and 4.2% reported depression, suicidal ideation, and suicide attempts, respectively. Adolescents with AR were significantly more likely to have negative mental health status, including suicidality than adolescents without AR. After multiple logistic regression analyses, perception of stress was most strongly associated with depression and suicidal ideation (adjusted odds ratio: 5.16 [95% confidence interval; 5.04-5.28], 4.81 [4.65-4.98], respectively). For suicide attempts, subjective unhappiness was most strongly associated (3.63 [3.47-3.79]) among adolescents with AR. Presence of AR itself was also associated with depression and suicidality (1.10 [1.08-1.11], 1.08 [1.06-1.10], 1.05 [1.01-1.08], respectively). CONCLUSION Adolescents with AR had significantly greater prevalence of depression and suicidality. Multidisciplinary team approaches, including psychological support, may be needed to prevent suicide among adolescents with AR, especially those with identifiable risk factors.
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Affiliation(s)
- Joo Young Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Young Joo Han
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Jun Hwa Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Seon Hui Jo
- Department of Biostatistics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Sung Hoon Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
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21
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Azmeh R, Greydanus DE, Agana MG, Dickson CA, Patel DR, Ischander MM, Lloyd RD. Update in Pediatric Asthma: Selected Issues. Dis Mon 2019; 66:100886. [PMID: 31570159 DOI: 10.1016/j.disamonth.2019.100886] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Asthma is a complex condition that affects 14% of the world's children and the approach to management includes both pharmacologic as well as non-pharmacologic strategies including attention to complex socioeconomic status phenomena. After an historical consideration of asthma, allergic and immunologic aspects of asthma in children and adolescents are presented. Concepts of socioeconomic aspects of asthma are considered along with environmental features and complications of asthma disparities. Also reviewed are links of asthma with mental health disorders, sleep disturbances and other comorbidities. A stepwise approach to asthma management is discussed that includes pharmacologic and non-pharmacologic strategies in the pediatric population. The role of immunotherapy and use of various immunomodulators are considered as well.
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Affiliation(s)
- Roua Azmeh
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States.
| | - Marisha G Agana
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Cheryl A Dickson
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States; Health Equity and Community Affairs, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, United States
| | - Dilip R Patel
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Mariam M Ischander
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Robert D Lloyd
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, Washington, United States
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22
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Akram F, Jennings TB, Stiller JW, Lowry CA, Postolache TT. Mood Worsening on Days with High Pollen Counts is associated with a Summer Pattern of Seasonality. Pteridines 2019; 30:133-141. [PMID: 31631951 PMCID: PMC6800045 DOI: 10.1515/pteridines-2019-0016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Summer/spring-type seasonal affective disorder (S-SAD) is the less common subtype of seasonal affective disorder and evidence regarding potential triggers of S-SAD is scarce. Recent reports support association of airborne-pollen with seasonal exacerbation of depression (mood seasonality) and timing of suicidal behavior. Therefore, we hypothesized that Old Order Amish (OOA) with summer/spring pattern of seasonality (abbreviated as summer pattern) and S-SAD will have significant mood worsening on high pollen days. Methods: A seasonal pattern of mood worsening and SAD parameters were estimated using Seasonal Pattern Assessment Questionnaire (SPAQ). Age- and gender-adjusted ANCOVAs and post hoc analyses were conducted to compare mood worsening on days with high pollen counts between summer-pattern vs no-summer-pattern of mood worsening, S-SAD vs no-S-SAD, winter-pattern vs no-winter-pattern of mood worsening, and W-SAD vs no-W-SAD groups. Results: The prevalence of S-SAD was 0.4%, while 4.5% of individuals had a summer pattern of mood seasonality. A statistically significant difference for mood worsening on high pollen days was observed between summer-pattern vs no-summer-pattern of mood worsening (p = 0.006). The significant association between S-SAD vs no-SAD groups (p = 0.032) for mood worsening on high pollen days did not withstand Bonferroni adjustment for multiple comparisons. No significant association was found for winter-pattern vs no-winter-pattern of mood worsening (p = 0.61) and for W-SAD vs no-W-SAD (p = 0.19) groups. Conclusion: Our results are consistent with previous studies implicating links between aeroallergen exposure and summer pattern of seasonality, but not the winter pattern of seasonality.
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Affiliation(s)
- Faisal Akram
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Tyler B Jennings
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - John W Stiller
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Christopher A Lowry
- Department of Integrative Physiology, Center for Neuroscience, and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO 80309, USA; Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO, 80045, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO 80045, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, 21201, USA; Saint Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, 20032, USA; Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO, 80045, USA; Amish Research Clinic of the University of Maryland, Lancaster, PA, 17602, USA
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