Asthma and d epression a study of 18 to 45 year old asthma patients
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Asthma and D epression A study of 18 to 45 year old asthma patients ?. Marre Andrée Wiltens 10 February 2011. Content. Netherlands Maastricht University Background Thesis Hypothesis Relevance Survey Data collection Caroline Theunissen Marre Andrée Wiltens Analysis Answers

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Asthma and D epression A study of 18 to 45 year old asthma patients ?

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Asthma and DepressionA study of 18 to 45 yearoldasthmapatients?

Marre Andrée Wiltens

10 February 2011


Content

  • Netherlands

    • Maastricht University

  • Background

  • Thesis

  • Hypothesis

  • Relevance

  • Survey

  • Data collection

    • Caroline Theunissen

    • Marre Andrée Wiltens

  • Analysis

  • Answers

  • Discussion

  • Literature

  • Questions?


The Netherlands

  • Geography

    • 16,033 sq mi

    • 12 provinces

    • Lowest point: -23 ft

    • Highest point: 2877 ft

  • General information

    • Capital: Amsterdam

    • Democracy

    • Queen Beatrix

    • Inhabitants:16,661,047


The Netherlands


  • MedicalFaculty

    • Curriculum

      • 6 year

      • Bachelor-Master

    • Educational system

      • ProblemBasedLearning

    • Students

      • +/- 320 per year

  • Finalyear:

    • Research (WESP)

    • Clinical (GEZP)


Background

  • Depression

    • Major healthproblem

      • Lifetime risk of depression is 17%1 in the generalpopulation

    • Associationwithincreasedprevalence of:

      • Chronicdiseases

      • Unhealthylifestyle

    • Precipitates and exacerbateschronicconditions

1 Kessler et al. (2005), Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Co-morbidity Survey Replication.


Background

  • Depression

    • Rate of depression is fourtimes higher1 in cancerpatients.

    • Patientswith:

      • Cardiovasculardiseases

      • Diabetes

      • Obesity

      • Asthma

        are more likely to have:

      • Currentdepression

      • A lifetime diagnosis of depression

      • A lifetime diagnosis of anxiety

1Pril (2004) Evidence report on the occurrence, assesment and treatment of depression in cancer patients.


Background

  • Asthma

    • Commonchronicinflammatorydisease of the airway

      • In 2008 7%1 of the adults

    • Characterisedby:

      • Breathlessness

      • Chesttightmess

      • Wheezing

      • Coughing

    • Psychosomaticdisease

      • Associationbetweenasthma and psychological factors

1 U.S. department of health and human services (2009), Summary Health Statistics for U.S. Adults: National Health Interview Survey 2008.


Background

  • Asthma and depression 2

    • Patientswithregularcomplaints are more likely to developpsychiatric disorders such as:

      • Depression

      • Sleeplessness

      • Anxiety

    • Severity of asthma is an index for the severity of the psychiatriccomplaints.

  • Asthma and depression 1

    • Asthmapatients are more likely to have:

      • Currentdepression

    • Psychological factors such as depressioninfluence:

      • Onset of asthma

      • Course of asthma

    • 18-25 yearoldasthmapatients more likely to developdepressionthen 50 to 65 years


Background

  • Asthma and depression 3

    • Considerableliteratureabouttreatment of depression in asthmapatients

    • Asthmapatientsthatsuffer a depression have:

      • Highermedicalutilizationcosts

      • Shorterlifeexpactancy

    • Depression is related to

      • More severeasthma

      • Poor asthmacontrol

      • Non-compliance of medication

      • Higherfrequencies of doctor’svisits


Relevance

  • RelationshipbetweenAsthma, depression and the specefic factors:

    • Asthma coping strategies

    • Asthmaknowledge

      is scarce


Relevance

Research:

  • Betterunderstanding

  • More awareness

    Better:

  • Screeningpossibilities

  • Treatmentoptions


Thesis

Studyquestions:

  • What is the correlationbetweenasthmaseverity and beingdepressed?

  • What is the correlationbetween the level of knowledgeaboutasthma and beingdepressed?

  • What is the correlationbetweenasthma coping skills and beingdepressed?


Hypothesis

  • The severity of asthmawillcontribute to the risk of beingdepressed.

  • Patientswith a higher level of knowledgeaboutasthmawillbelesslikely to bedepressed.

  • Individualswithbetterasthma coping skillswillbelesslikely to bedepressed.


Survey

  • Surveycomponents

    • 7 instruments:

      • 3 validated

        • KASE-AQ (knowledge)

        • DURHAM (depression)

        • ASCS (coping)

      • 4 non-validated

        • Asthmaseverity

        • General understanding/motivation

        • Lifestyle

        • Socio-demographicinformation


Survey

Eligibility

Difficulties

Validation

Lengthy

KASE-AQ (knowledge):

Difficultlanguage

Outdatedquestions

2 questionsexcluded

  • Inclusion criteria:

    • 18 to 45 yearsold

    • Asthma diagnosis

    • Understanding of and able to read the Englishlanguage

  • Exclusion criteria:

    • Priorparticipation in this research project


Data Collection

Caroline Theunissen

Marre Andrée Wiltens

2 clinics:

Rockford

Freeport

Enrolled 25 patients

  • 3 clinics

    • Rockford

    • Freeport

    • DeKalb

  • Enlisted 80 patients


Answers

  • There is a correlationbetweendepression and

    • Asthmaseverity

    • Asthma coping skills

  • There is nocorrelationbetweendepression and

    • Asthmaknowledge

  • However, the mean score of the DURHAM is significant higher in patientswith low knowledge


Discussion

  • Next steps:


Literature

  • Kessler, R.C., Berglund, P., Demler, O., Jin, R, Merikangas, K.R., Walters, E.E.; Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication; Arch Gen Psychiatry 2005; 62(7):593-602.

  • Donohue, J.M., Pincus, H.A.; Reducing the societal burden of depression: a review of economic costs, quality of care and effects of treatment;Pharmacoeconomics 2007; 25(1):7-24.

  • Fan, A.Z., Strine, T.W., Huang, Y., Murray, M.R., Musingo,S. Jiles,R., Mokdad, A.H.; Self-rated Depression and Physician-Diagnosed Depression and Anxiety in Florida Adults: Behavioral Risk Factor Surveillance System, 2006; PrevChronDis 2009; 6(1):1-14.

  • Pril, W.; Evidence report on the occurrence, assessment and treatment of depression in cancer patients; J Natl Cancer Inst Monogr 2004; 2004(32):32-39.

  • Snyderman, D., Wynn, D.; Depression in Cancer Patients; Prim Care Clin Office Pract 2009; 36(4):703-719.

  • Strine, T.W., Mokdad, A.H., Balluz, L.S., Gonzalez, O., Crider, R., Berry, J.T., Kroenke, K.; Depression and Anxiety in the United States: Findings From the 2006 Behavioral Risk Factor Surveillance System; 2008; 59(12): 1383-1390.

  • Corbridge, S., Corbridge, T.C.; Asthma in Adolescents and Adults; AJN 2010; 110(5):28-38.

  • U.S. Department of health and human services; Summary Health Statistics dor U.S. Adults: National Health Interview Survey 2008;Hyatsville: Centers for disease Control and Prevention 2009.

  • Dunbar, F.; Mind and body: psychosomatic medicine;New York, Random House; 1947.

  • Opolski, M., Wilson, I.; Asthma and depression: a pragmatic review of the literature and reccomendations for future research; ClinPractEpidemiolMent Health 2005; 1:18-24.

  • Strine, T.W., Mokdad, A.H., Balluz, L.S., Berry, J.T., Gonzales, O.; Impact of Depression and anxiety on quality of life, health behaviors and asthma control among adults in the United States with asthma, 2006; J Asthma 2008; 45(2):123-133.

  • Katon, W., Lozano, P., Russo, J., McCauley, E., Ridchardson, L., Bush, T.; The prevalence of DSM-IV anxiety and depressive disorders in Youth with Asthma to controls; J Adolesc Health 2007; 41(5):455-463.

  • Aalto, A-M., Härkäpää, K., Aro, A.R., Rissanen, P.; Ways of coping with asthma in everyday life Validation of the Asthma Specific Coping Scale; J Psychosom Res 2002; 53(6):1061-1069.

  • Wigal, J.K., Stout, C., Brandon, M., Winder, J.A., McCounnaughy, K., Creer, T.L., Kotses, H.; Knowledge, Attitude and Self-Efficacy Asthma Questionnaire for asthma knowledge; Chest 1993; 104(4):1144-1148.

  • Doetch, T.M., Alger, B.H., Glasser, M., Levenstein, J.; Detecting Depression In Elderly outpatients: Findings From Depression Sympotom Scales and the Darthmouth COOP Charts;Fam Med 1994; 26(8):519-523.


Questions


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