Psychiatry - October 2008 - (Page 49)

[the interface] explored mood disorders among 50 outpatients with asthma and, in comparison with a national probability sample, found higher lifetime rates.4 Among 317 inner-city patients being treated for asthma, Goethe and colleagues found that 55 percent scored positively for depression.5 Using data from the World Mental Health Survey, investigators examined 18 population surveys from 17 countries (over 85 with attempts (ORc, 1.98; 95% CI, 1.42–2.76), but not suicidal ideation without attempts (ORc, 1.09; 95% CI, 0.81–1.45). Finally, if mood disorders are genuinely over-represented in asthmatic probands, one would wonder about the corresponding rates of mood disorders in family members, as well. Wamboldt and colleagues examined this relationship in a clinical sample of 145 first- The data [in this article] indicate that among various community and clinical populations of adolescent and adult patients with asthma, there appears to be a higher-thanexpected prevalence rate of mood and anxiety disorders. However, these data must be interpreted with caution thousand individuals) and found that depressive disorders were more frequent among those participants with asthma.6 In a Dutch sample of older adults, researchers found a statistical association between asthmatic disease and major depression.7 Finally, in a methodologically well executed German study, Goodwin, Jacobi, and Thefeld found that current asthma (non-severe) was clearly associated with an increased likelihood of an affective disorder (OR, 2.42; 95% CI, 1.03–5.72).8 Given the prevalence of mood disorders among individuals with asthma, one might wonder about whether there is a correspondingly higher rate in this population of suicidal ideation and/or suicide attempts. Examining data from the National Comorbidity Survey Replication study, Clarke and colleagues initially determined that 12 percent of the overall sample suffered from asthma.9 In further analyses, the researchers found a statistically significant association between asthma and suicidal ideation degree relatives of asthmatic adolescents, and found a link between asthma and familial affective disorders.10 Anxiety disorders in asthmatics. In addition to the studies exploring mood disorders and found that, compared with controls, the former had a significantly greater number of anxiety disorders.12 Goodwin, Jacobi, and Thefeld explored anxiety disorders and their relationships to asthma among a German sample of more than 7,000 individuals.8 Current severe asthma symptoms were associated with a significantly increased likelihood of any anxiety disorder (OR, 2.65; 95% CI, 1.35–5.18). In an international study, Scott and colleagues found an association between asthma and the presence of any anxiety disorder.6 Finally, in a study of 82 children and adolescents, Vila and colleagues found that generalized anxiety disorder was the most common diagnosis among their asthmatic population and affected nearly 30 percent of participants.13 Panic disorder. In addition to any type of anxiety disorder, a number of studies have examined the prevalence of panic disorder in asthmatic populations. In the general population, the prevalence of panic In our experience, mood and anxiety disorders are the most common psychiatric syndromes encountered in chronic disease states. Thus, these psychiatric findings may not be specific to the asthma disease state, itself, but rather to chronicity. among asthmatics, there are a number of studies that have examined relationships between asthma and various anxiety disorders. Any anxiety disorder. Among 20 adult patients with brittle asthma, Garden and Ayres found that 35 percent evidenced a lifetime history of some type of anxiety disorder, compared to 15 percent of controls.11 Bussing, Burket, and Kelleher examined 37 children with asthma disorder is 4.7 percent.14 In a study of 93 asthmatics, Carr and colleagues found that 23 percent reported histories of panic attacks.15 In an Italian sample of adults, Perna and colleagues found higher rates of panic disorder than the rates encountered in the general population.16 Brown, Khan, and Mahadi found a prevalence rate for panic disorder of 16 percent in their sample of asthmatics.3 Finally, in a Brazilian sample, Nascimento and [OCTOBER] Psychiatry 2008 49

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Psychiatry - October 2008 Editor’s Message Editorial Advisory Board Contents Psych Rx Treatment of Migraine and the Role of Psychiatric Medications Play Therapy: A Case-based Example of a Nondirective Approach Delirium and Antipsychotics: A Systematic Review of Epidemiologyand Somatic Treatment Options Severely Mood-disordered Youth Respond Less Well to Treatment in a Community Clinic than Youth with Bipolar Disorder Beyond Informed Consent: The Ethics of Informing, Anticipating, and Warning Asthma: Wheezing, Woes, and Worries Classified Advertising Journal Watch Information for Authors

Psychiatry - October 2008

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