Increased mental health care use in adults after asthma diagnosis

Published online: April 7, 2017

Living with asthma is associated with a decrease in quality of life due to reductions in activities of daily living and an increase in psychological stress, all of which are known to negatively impact mental health. Little is known, however, about how diagnoses of asthma in adulthood influence mental health service utilization.

In a recent article published by The Journal of Allergy and Clinical Immunology: In Practice, To and colleagues quantified the burden of mental health conditions in the adult asthma population. Specifically, it compared the risk of mental health service utilization (hospital admissions, emergency department visits, and outpatient physician visits) before and after the diagnosis of asthma.

The study used health administrative (billing) databases from a universal health care system in Ontario, Canada to study residents aged 25 to 65 years with new physician-diagnosed asthma over a seven-year period (2005 to 2012). A total of 145,881 adults were diagnosed with asthma over this period and their mental health service utilization before and after asthma diagnosis was examined.

The Authors found that, more than 1 in 4 adults (27%) used mental health services in the 1-year after asthma diagnosis. Compared to the year before asthma diagnosis, the risk of emergency department visits for any mental disorders was 13% higher and the risk of outpatient physician visits for substance-related disorders was 21% higher in the 1-year after. In the second year after asthma diagnosis, the risk of substance-related disorders increased even more to be 37% higher. Finally, the risk of hospitalizations for anxiety disorders was significantly higher in the two years after asthma diagnosis.

These findings highlight the need to assess the mental health needs of adult patients after new diagnoses of asthma, with particular attention to anxiety and substance-related disorders. Further research is needed to better understand what factors are driving mental health service utilization in the asthma population, including whether it is solely for worsening mental health or, in part, because of worsening asthma symptoms.  Further study is also needed to better understand the causal mechanisms underlying the association between mental disorders and asthma.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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