Onset of depressive symptoms among adults with asthma: results from a longitudinal observational cohort

Aims: Individuals with asthma may be at increased risk of depression, but few studies have identified precursors to the onset of depression. The study goal was to identify risk factors for depression onset among a community-based sample of adults with asthma. Methods: Data were obtained from three telephone interviews conducted at 2-yearly intervals on a longitudinal cohort of adults with asthma (n=439). The Center for Epidemiologic Studies Depression scale (CESD) was used to measure depressive symptoms. Multiple regression analyses tested associations of sociodemographic and health-related variables with depression prevalence (cross-sectional analyses) and incident depression (longitudinal analyses). Results: 15% of subjects were classified as depressed (CESD >= 23) at each interview. Individuals depressed at baseline were more likely to drop out (OR=1.76 [95% CI 1.05, 2.96]). Low perceived control of asthma (measured with the Perceived Control of Asthma Questionnaire [PCAQ]) exhibited the most consistent association with depression. Lower PCAQ was cross-sectionally associated with depression (OR=0.51 per 0.5 SD difference in PCAQ [0.35, 0.75]). Onset of depression was noted in 38 individuals. Decrease in perceived control at follow-up was associated with depression onset (OR=7.47 [2.15, 26.01]). Conclusions: Low perceived control of asthma predicted depression onset among adults with asthma. This risk factor may respond to self-management education. (c) 2010 Primary Care Respiratory Society UK. All rights reserved. PP Katz et al. Prim Care Resp J 2010; 19(3): 223-230 doi:10.4104/pcrj.2010.00012