Depression symptoms and quality of life among individuals with aspirin-exacerbated respiratory disease.

OBJECTIVE: Patients with aspirin-exacerbated respiratory disease (AERD) have high disease burden due to the severity of asthma and sinonasal symptoms. There is limited research on the psychological well-being and subjective experiences of patients with AERD. This study examined levels of depression symptoms, asthma-related quality of life and asthma control among AERD patients. METHODS: Thirty-two adults with AERD and 39 patients without AERD (asthma-only) were recruited from outpatient asthma/allergy clinics. The sample was largely comprised of ethnic minority, inner-city patients who ranged in age from 19 to 84 years old. Participants completed the Beck Depression Inventory (BDI), the Mini Asthma Quality of Life Questionnaire (Mini AQLQ), a self-report rating of asthma severity and spirometry testing. Asthma control and severity were determined following national guidelines. RESULTS: AERD patients reported lower levels of depression symptoms (p = 0.049), better overall asthma-related quality of life (p < 0.001), and perceived their asthma to be less severe (p = 0.01) compared to asthma-only patients. However, clinician ratings of asthma severity were more severe for AERD than asthma-only patients (p = 0.006). No significant differences were found between the groups on asthma controller medications or oral corticosteroid bursts for asthma. CONCLUSIONS: AERD patients may be resilient given their low levels of depression symptoms and positive views of asthma-related impairment despite higher clinician-rated asthma severity. The adult onset nature of asthma in AERD might be a protective factor on mental health. Future studies should explore mechanisms linking AERD and positive psychological health outcomes and subjective perception of asthma.

[Differences in sense of coherence in difficult and aspirin-induced asthma and it's links with severity of panic and depressive symptoms in subgroups of women and men]. / Róznice w poczuciu koherencji w astmie ciezkiej, trudnej i w astmie z nadwrazliwoscia na aspiryne (aspirynowej) oraz jej zwiazki z nasileniem objawów zespolu leku napadowego i depresji w podgrupach kobiet i mezczyzn.

AIM: The author examined psychiatrically a group of 106 patients with difficult asthma and 100 patients with aspirin-induced asthma. The special interest of the study were differences in sense of coherence in both groups and it's links with severity of panic and depressive symptoms in subgroups of asthmatic women and men. METHODS: 106 consecutive adults with confirmed, physician-diagnosed difficult asthma and 100 patients with aspirin-induced asthma underwent psychiatric interview and assessment using M.I.N.I 5.0, Beck Depression Inventory (BDI), Panic And Agoraphobia Scale (PAS) and Sense of Coherence Scale (SOC-29). Psychiatric assessment was performed by an experienced liaison psychiatrist according to ICD-10 and DSM-IV diagnosis. In the difficult asthma group, there were 78 women (74%) and 28 men (26%). The average age was 51.3 (SD = 14.5) for women and 47.5 (SD = 12.7) for men. In aspirin induced asthma group there were 66 women (66%) and 34 men (34%). The average age was 52.7 (SD = 12.3) for women and 48.8 (SD = 13.0) for men. RESULTS: In both groups of asthmatic patients women were the majority (74% with difficult asthma and 66% with aspirin-induced asthma) with a much higher level of anxiety and depressive symptoms than men. General coherence and coherence measured in all three sub-scales were lower in the difficult asthma group, especially in women with severe panic and depressive symptoms. CONCLUSIONS: It is possible that differences of coherence affect the development, course and severity of anxiety and depressive symptoms in asthmatic women and men. It may play a special role in development of difficult asthma especially among women.

[Links between defence mechanisms and severity of symptoms of panic disorder and depression in women and men with difficult and aspirin-induced asthma]. / Zwiazek mechanizmów obronnych osobowosci z nasileniem objawów zespolu leku napadowego i depresji u kobiet i mezczyzn z astma ciezka i trudna oraz-astma aspirynowa.

AIM: The author examined psychiatrically a group of 106 patients with difficult asthma and 100 patients with aspirin-induced asthma. The special interest of the study were links between defence mechanisms used by women and men from both groups and severity of their panic and depressive symptoms. METHODS: 106 consecutive adults with confirmed, physician-diagnosed difficult asthma and 100 patients with aspirin-induced asthma underwent the psychiatric interview and assessment using M.I.N.I 5.0, Beck Depression Inventory (BDI), Panic and Agoraphobia Scale (PAS) and the Defence Style Questionnaire. Psychiatric assessment was performed by an experienced liaison psychiatrist according to ICD-10 and DSM-IV diagnosis. In the difficult asthma group there were 78 women (74%) and 28 men (26%). The average age was 51.3 (SD = 14.5) for women and 47.5 (SD = 12.7) for men. In the aspirin induced asthma group there were 66 women (66%) and 34 men (34%). The average age was 52.7 (SD = 12.3) for women and 48.8 (SD = 13.0) for men. RESULTS: In both groups of asthmatic patients women were majority (74% with difficult asthma and 66% with aspirin-induced asthma) with higher level of anxiety and depressive symptoms than men. Generally in difficult asthma group significantly more often than in aspirin-induced asthma neurotic and immature defence mechanisms were used. In both groups, either in women and in men there was a strong tendency to decrease the use of mature defence mechanisms and increase the use of neurotic and immature defence mechanisms in association with an increase of severity of panic and depressive symptoms. CONCLUSIONS: It is possible that differences in defence mechanisms used by women and men with difficult asthma affect the development, course and severity of their anxiety and depressive symptoms. This may play a special role in the development of difficult asthma phenomenon.

[General differences in the intensity of catastrophic interpretation of body sensations and it's specific links with severity of symptoms of panic disorder and depression in women and men with difficult and aspirin-induced asthma]. / Ogólne róznice w nasileniu katastroficznej interpretacji doznan somatycznych oraz jej szczególowy zwiazek z nasileniem objawów zespolu leku napadowego i depresji u kobiet i mezczyzn z astma ciezka i trudna oraz astma aspirynowa.

AIM: The author examined psychiatrically a group of 106 patients with difficult asthma and 100 patients with aspirin-induced asthma. The special interest of the study were differences in the intensity of catastrophic interpretation of body sensations and it's specific links with severity of symptoms of panic disorder and depression in women and men from both groups. METHOD: 106 consecutive adults with confirmed, physician-diagnosed difficult asthma and 100 patients with aspirin-induced asthma underwent a psychiatric interview and assessment using M.I.N.I 5.0, Beck Depression Inventory (BDI), Panic And Agoraphobia Scale (PAS) and Body Sensations Interpretation Questionnaire (BSIQ). Psychiatric assessment was performed by an experienced liaison psychiatrist according to ICD-10 and DSM-IV diagnosis. In the difficult asthma group there were 78 women (74%) and 28 men (26%). The average age was 51.3 (SD = 14.5) for women and 47.5 (SD = 12.7) for men. In aspirin induced asthma group, there were 66 women (66%) and 34 men (34%). The average age was 52.7 (SD = 12.3) for women and 48.8 (SD = 13.0) for men. RESULTS: General intensity of catastrophic interpretation ofbody sensations was much higher in the difficult asthma group. In both groups of asthmatic patients women were the majority, with more frequent severe panic and depressive symptoms than men. Nevertheless there was a very similar and strong tendency to increased intensity of catastrophic interpretation due to severity of both panic and depressive symptoms in subgroups of women and men with difficult and aspirin-induced asthma. CONCLUSIONS: It is possible that differences in the intensity of catastrophic interpretation of body sensations used by women and men with difficult asthma affect the development, course and severity of their panic and depressive symptoms. This may play a special role in development of difficult asthma phenomenon.

[Gender and presence of profound psychological traumas versus comorbidity of panic disorder and depression in difficult and aspirin-induced asthma]. / Plec i obecnosc doznanych urazów psychicznych a wspólwystepowanie zespolu leku napadowego i depresji w astmie ciezkiej i trudnej oraz w astmie aspirynowej.

AIM: The author examined psychiatrically a group of 106 patients with difficult asthma and 100 patients with aspirin-induced asthma. The special interest of the study was the careful analysis of the time, context and content of different psychological traumas that the patients from both groups had throughout their lives. METHODS: 106 consecutive adults with confirmed, physician-diagnosed difficult asthma and 100 patients with aspirin-induced asthma underwent psychiatric interview and assessment using M.I.N.I 5.0, Beck Depression Inventory (BDI) and Panic And Agoraphobia Scale (PAS). Psychiatric assessment was performed by an experienced liaison psychiatrist according to ICD-10 and DSM-IV diagnosis. In the difficult asthma group, there were 78 women (74%) and 28 men (26%). The average age was 51.3 (SD = 14.5) for women and 47.5 (SD = 12.7) for men. In the aspirin induced asthma group, there were 66 women (66%) and 34 men (34%). The average age was 52.7 (SD = 12.3) for women and 48.8 (SD = 13.0) for men. RESULTS: In both groups of asthmatic patients women were majority (74% with difficult asthma and 66% with aspirin-induced asthma) with a higher level of anxiety and depressive symptoms than men. It may be due to specific trauma of suffering and/or death of an emotionally close person, which occurred in adulthood. This kind of trauma may have impact on the aetiology of both panic disorder and depression. Women are more exposed to this sort of trauma due to their social role. CONCLUSIONS: It is possible, that psychological trauma affects the development, course and severity of anxiety and depressive symptoms in asthmatic patients. It may play a special role in development of difficult asthma.