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Mental Disorders and Asthma in the Community
Renee D. Goodwin, PhD, MPH;
Frank Jacobi, PhD;
Wolfgang Thefeld, MD
Arch Gen Psychiatry. 2003;60:1125-1130.
Objective To determine the association between asthma and mental disorders among adults in the community.
Setting Germany.
Participants Representative sample of the general population aged 18 to 65 years.
Main Outcome Measures Diagnoses of current (the past 4 weeks) and lifetime asthma were based on physician diagnosis; current and lifetime DSM-IV mental disorders were assessed using the Composite International Diagnostic Interview.
Results Current severe asthma (the past 4 weeks) was associated with a significantly increased likelihood of any anxiety disorder (odds ratio [OR], 2.65; 95% confidence interval [CI], 1.35-5.18), specific phobia (OR, 4.78; 95% CI, 2.35-4.05), panic disorder (OR, 4.61; 95% CI, 1.09-9.4), and panic attacks (OR, 4.12; 95% CI, 1.32-12.8). Lifetime severe asthma was associated with the increased likelihood of any anxiety disorder (OR, 2.09; 1.3-3.36), panic disorder (OR, 2.61; 95% CI, 1.29-5.25), panic attacks (OR, 2.84; 95% CI, 1.66, 4.89), social phobia (OR, 3.28; 95% CI, 1.42, 7.59), specific phobia (OR, 2.93; 95% CI, 1.71-5.0), generalized anxiety disorder (OR, 5.51; 95% CI, 2.29-13.22), and bipolar disorder (OR, 5.64; 95% CI, 1.95-16.35). Current nonsevere asthma was associated with the increased likelihood of any affective disorder (OR, 2.42; 95% CI, 1.03-5.72); and lifetime nonsevere asthma was associated with increased odds of any anxiety disorder (OR, 1.51; 95% CI, 1.0-2.32), anxiety disorder not otherwise specified (OR, 2.08; 95% CI, 1.03-4.23), and any somatoform disorder (OR, 1.7; 95% CI, 1.14-2.53).
Conclusions To our knowledge, these findings are consistent with and extend the findings of previous reports by providing the first available information on the association between physician-diagnosed asthma and DSM-IV mental disorders in a representative population sample of adults. Our results suggest an association between asthma and a range of mental disorders. Longitudinal studies that can examine the sequence of onset and the role of genetic and environmental factors in the association between asthma and affective and anxiety disorders are needed next to further elucidate possible shared causative mechanisms.
From the Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany (Drs Goodwin and Jacobi); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (Dr Goodwin); and the Robert-Koch-Institut, Berlin, Germany (Dr Thefeld).
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RAPID RESPONSES TO THIS ARTICLE
Asthma and panic disorder spectrum
Antonio E Nardi
Arch Gen Psychiatry Online, 26 Dec 2003.
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