Anxiety and depression in relation to respiratory symptoms and asthma

The aim of this investigation was to study the relationship between psychologic status and respiratory health. The study comprised 715 persons aged 22 to 44 who participated in the European Commission Respiratory Health Survey. The study included a structural interview, spirometry, methacholine challenge, peak flow diary, skin prick test, and measurement of eosinophil activity in peripheral blood. The psychologic status was assessed by means of the hospital anxiety and depression (HAD) scale questionnaire. A significant correlation was found between anxiety and depression and the report of asthma-related symptoms, such as attacks of breathlessness after activity and waking with attacks of breathlessness (p < 0.01). However, there was no significant correlation between anxiety or depression and a self-reported diagnosis of asthma or objective asthma-related variables, such as peak flow variability or response to methacholine. When evaluating the combined influence of psychologic factors and objective variables, HAD score correlated independently with reported wheezing (p < 0.05), waking with attacks of breathlessness (p < 0.01), waking with chest tightness, attacks of breathlessness when at rest, and attacks of breathlessness after activity (p < 0.001). We conclude that there is an association between reported respiratory symptoms and psychologic status. However, there was no evidence that patients with diagnosed bronchial asthma had more anxiety and depression than those without asthma. This result indicates that it may be valuable to include psychologic status indicators in respiratory symptom questionnaires.