Close Correlation Between Anxiety, Depression, and Asthma Control

Respir Med. 2010 Jan;104(1):22-8. doi: 10.1016/j.rmed.2009.08.005. Epub 2009 Sep 4.


Background: We investigated the correlation between patients' characteristics, including anxiety and depression, and the level of asthma control evaluated by asthma control test (ACT), a self-administered validated questionnaire.

Methods: This is a cross-sectional study on asthmatic outpatients of three Italian hospitals. Demographic data, spirometry, anxiety and depression scores as well as the level of asthma control from 315 patients were collected.

Results: Patients with poorly controlled asthma were more frequently women, older, with a worse pulmonary function, obese, more anxious and/or more depressed. Four different independent factors associated with poor asthma control evaluated by ACT have been found: FEV(1)<60% (odds ratio, OR: 6.52), anxiety (OR: 3.76), age > or =65 years (OR: 2.69), and depression (OR: 2.45). The presence of anxiety and depression was associated with a higher healthcare utilization. Finally, we found a high level of agreement between ACT and multidimensional GINA approach in evaluating asthma control, with a concordance in 239 patients (81% of the population).

Conclusion: There is a close correlation between anxiety and depression, and a poor asthma. A better understanding of this association may have major clinical implications, mainly in patients with poor controlled asthma in whom the presence of anxiety and depression should be investigated.

Publication types

  • Multicenter Study
  • Validation Study

MeSH terms

  • Adult
  • Anti-Asthmatic Agents / therapeutic use*
  • Anxiety Disorders / complications*
  • Asthma / drug therapy*
  • Asthma / psychology
  • Cross-Sectional Studies
  • Depressive Disorder / complications*
  • Female
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Compliance
  • Quality of Life
  • Self Care / methods
  • Severity of Illness Index
  • Surveys and Questionnaires


  • Anti-Asthmatic Agents