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Association between asthma and depression

Published online: November 10, 2018

Asthma is characterized by sudden and unexpected episodes of airway obstruction, such as worsening asthma or exacerbations. Depression and asthma are common comorbid diseases and mood disorders in patients with asthma are associated with poor asthma outcomes such as decreased lung function, more frequent emergency department visits and reduced quality of life. Previous epidemiological studies have assessed the temporal association between depression and asthma, however, the results have remained elusive.

In a recent study published in The Journal of Allergy and Clinical Immunology: In Practice, Choi and colleagues examined the bidirectional association between asthma and depression. In the study, the authors used the national cohort samples from the Korean Health Insurance Review and Assessment Service and obtained the hazard ratio (HR) of asthma for depression (study 1) and depression for asthma (study 2) using a Cox proportional hazards model.
In Study 1, two cohorts composed of 112,524 people with asthma and the same number of control participants (control 1) were selected from the database between 2002 and 2012. 7.4% of participants in the asthma cohort were diagnosed with depression during the surveillance period, while, 5.5% of participants in the control 1 cohort were diagnosed with depression. In Study 2, two cohorts composed of 52,535 people with depression and 201,140 controls (control 2) were selected from the database during the same period. 11.3% of participants in the depression cohort were newly diagnosed with asthma, while 9.2% of participants in the control 2 were diagnosed with asthma during the same period.

This study found an increased risk of subsequent development of depression in patients with asthma. Similarly, depression is associated with subsequent asthma development, suggesting there is a sequential bidirectional association between the two diseases. Thus, it is important for physicians to be aware of potential asthma or depression development in patients with depression or asthma. Depressive symptoms and uncontrolled asthma are both modifiable factors that could be used to control each disease.

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