Abstract
Background: The association between chronic respiratory disease and psychological dysfunction has become increasingly apparent in recent years through epidemiological studies, and is associated with poor outcomes of all types. Research and treatment guidelines increasingly emphasize the need to improve functional outcomes, and psychological interventions may well be a cost-effective way to do so.
Method: We used psychological self-report measures with demographic and disease-related factors from patients with difficult to treat asthma in the WATCH Cohort to estimate the prevalence of psychological dysfunction, the association of psychological dysfunction with disease-related factors and contribution of such dysfunction to a range of clinically important outcomes.
Results: 'Borderline or above' scores on the Hospital Anxiety & Depression Scale were present in 27% of patients for depression, and 38% for anxiety. Poor asthma control (>1.25 on Asthma Control Questionnaire) was identified in 82% of patients.
A multiple linear regression model (age/gender corrected), including both anxiety and depression strongly predicted perceived breathlessness, F(4,106) = 28.22, p < .001, R2=.53, with both factors independently predicting variance, Bs > .77, ts>2.48, ps < .003. Anxiety and depression also weakly predicted asthma control, F(4,109) = 3.99, p=.005, R2 = .13.
Discussion: Our findings highlight the need to understand psychological predictors of disease-related outcomes and the possible benefits of psychological interventions. The longitudinal nature of the WATCH study allows future study of how psychological interventions can benefit patients.
- Copyright ©the authors 2016