A32-17 Depressive Symptoms Worsen Asthma Control

Rationale Asthma and depression are common diseases, which frequently co-exist. In asthma, the presence of depression is associated with increased emergency department visits and hospitalizations, and poorer quality of life. The combination of co-morbid asthma and depression is associated with worse asthma outcomes, yet little is understood about this interaction. This project set out to better understand the effects depressive symptoms have on different asthma outcomes. Methods A secondary data analysis of 3 previously published clinical trials in people with asthma was conducted. Two of the prior trials included adults with obesity and asthma with poorly controlled symptoms (Trial of roflumilast in asthma [TRIM, n = 38] and Asthma BMI baseline study [ABBS, n = 102]), while one trial included people over the age of 15 with asthma and uncontrolled symptoms (Trial of the effect of drug presentation on asthma outcomes [TAPE, n = 601]). Validated depressive symptom surveys were used to determine presence of clinically significant depressive symptoms. We investigated the association between quality of life (short-form 36 [SF-36]), asthma symptoms (asthma symptom severity index [ASUI]), spirometry, and exacerbations with depressive symptoms, adjusting for sex, race and body mass index. Results In people with asthma and elevated depressive symptoms, quality of life (SF-36 survey) was significantly lower in both the TRIM/ABBS population (p < 0.01) as well as in the TAPE population (p < 0.01). Asthma symptoms (ASUI survey) were not significantly different between those with and without depressive symptoms in the TRIM/ABBS population; in the TAPE population, those with clinically significant depressive symptoms had worse asthma symptom control (p < 0.01) (Figure 1). In the TRIM/ABBS population, clinically significant depressive symptoms were associated with increased exacerbations (p = 0.05), while this relationship was not seen in the TAPE population (p = 0.89). Spirometry values, including FEV1, FVC and % bronchodilator reversibility were not significantly different between those with and without depressive symptoms. Conclusions The presence of depressive symptoms in asthma is associated with worse quality of life, but not lung function. In a population with obesity and asthma, we found no relationship between depressive symptoms and worse asthma symptoms, but more exacerbations. In a population with a lower body mass index, depressive symptoms were associated with worse asthma symptoms, but not increased exacerbations. Depression may have a differential effect on people with asthma in different weight categories. This abstract is funded by: American Lung Association-Airways Clinical Research Center