The association of comorbid anxiety and depression with asthma-related quality of life and symptom perception in adults

Respirology. 2008 Sep;13(5):695-702. doi: 10.1111/j.1440-1843.2008.01310.x. Epub 2008 May 29.


Background and objective: There are limited data on the association and interaction between anxiety and depression comorbidity and asthma-related quality of life (AQOL) and symptom perception. This study evaluated these associations in patients subsequent to an emergency department (ED) visit for asthma.

Methods: This was a cross-sectional study of 110 (38 male) adult asthma patients (mean age 42 years), who had visited an ED in the previous 18 months. Participants completed the hospital anxiety and depression scale, measures of AQOL and the asthma symptom checklist.

Results: Depression symptoms independently showed a significant negative association with AQOL after controlling for depression/anxiety, age, gender, smoking status and ED visits in the previous 12 months (ED-12). Overall, anxiety and depression symptoms accounted for 28.3% of the variance in AQOL. Greater anxiety was associated with increased perception of asthma-specific panic-fear and hyperventilation symptoms during an asthma attack, irrespective of depression status. Categorical analyses of groups of patients, differentiated by psychometric properties on the hospital anxiety and depression scale (anxiety vs normal, anxiety and depression vs normal depression) confirmed most results. However, for the anxiety group there was a significant association with the AQOL domains of emotional functioning and response to environmental stimuli, after controlling for depression symptoms.

Conclusions: The negative association of depression symptom scores with AQOL and of anxiety with increased panic-fear and hyperventilation symptoms suggests a potential role for interventions addressing this psychological comorbidity, in order to improve AQOL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety / complications*
  • Asthma / psychology*
  • Cross-Sectional Studies
  • Depression / complications*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psychometrics
  • Quality of Life*
  • Regression Analysis
  • Self Concept*
  • Severity of Illness Index