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Prospective impact of panic disorder and panic-anxiety on asthma control, health service use, and quality of life in adult patients with asthma over a 4-year follow-up.
Psychosom Med 2014; 76(2):147-55PM

Abstract

Background Panic disorder (PD) is a common anxiety disorder among asthmatic patients with overlapping symptoms (e.g., hyperventilation). However, the longitudinal impact of PD on asthma control remains poorly understood. This study assessed the impact of PD and panic-anxiety on asthma control over a 4.3-year follow-up in 643 adult asthmatic patients. Methods Consecutive patients presenting to a tertiary asthma clinic underwent a sociodemographic, medical history, and psychiatric (Primary Care Evaluation of Mental Disorders) interview and completed questionnaires including the Anxiety Sensitivity Index (ASI) to assess panic-anxiety. At follow-up, patients completed the Asthma Control (ACQ) and Asthma Quality of Life (AQLQ) questionnaires and reported emergency department visits and hospitalizations during the follow-up. Results Baseline frequency of PD was 10% (n = 65). In fully adjusted models, analyses revealed that PD and ASI scores predicted worse follow-up ACQ total scores (β = 0.292, p = .037; β = 0.012, p = .003) but not AQLQ total scores. ASI scores also predicted greater nocturnal and waking symptoms, activity limitations, and bronchodilator use on the ACQ (β = 0.012-0.018, p < .05) as well as lower symptom (β = -0.012, p = .006) and emotional distress (β = -0.014, p = .002) subscale scores on the AQLQ. Neither PD nor ASI scores were associated with hospitalizations, although ASI scores (but not PD) were associated with an increased risk of emergency department visits (relative risk = 1.023, 95% confidence interval = 1.001-1.044). Conclusions PD and anxiety sensitivity are prospectively associated with poorer asthma control and may be important targets for treatment.

Authors+Show Affiliations

Department of Psychology, University of Quebec at Montreal, PO Box 8888, Succursale Center-Ville, Montreal, Quebec, Canada H3C 3P8. k-lavoie@crhsc.rtss.qc.ca.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24470131

Citation

Favreau, Helene, et al. "Prospective Impact of Panic Disorder and Panic-anxiety On Asthma Control, Health Service Use, and Quality of Life in Adult Patients With Asthma Over a 4-year Follow-up." Psychosomatic Medicine, vol. 76, no. 2, 2014, pp. 147-55.
Favreau H, Bacon SL, Labrecque M, et al. Prospective impact of panic disorder and panic-anxiety on asthma control, health service use, and quality of life in adult patients with asthma over a 4-year follow-up. Psychosom Med. 2014;76(2):147-55.
Favreau, H., Bacon, S. L., Labrecque, M., & Lavoie, K. L. (2014). Prospective impact of panic disorder and panic-anxiety on asthma control, health service use, and quality of life in adult patients with asthma over a 4-year follow-up. Psychosomatic Medicine, 76(2), pp. 147-55. doi:10.1097/PSY.0000000000000032.
Favreau H, et al. Prospective Impact of Panic Disorder and Panic-anxiety On Asthma Control, Health Service Use, and Quality of Life in Adult Patients With Asthma Over a 4-year Follow-up. Psychosom Med. 2014;76(2):147-55. PubMed PMID: 24470131.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective impact of panic disorder and panic-anxiety on asthma control, health service use, and quality of life in adult patients with asthma over a 4-year follow-up. AU - Favreau,Helene, AU - Bacon,Simon L, AU - Labrecque,Manon, AU - Lavoie,Kim L, Y1 - 2014/01/26/ PY - 2014/1/29/entrez PY - 2014/1/29/pubmed PY - 2014/10/1/medline KW - anxiety sensitivity KW - asthma control KW - asthma quality of life KW - health service use SP - 147 EP - 55 JF - Psychosomatic medicine JO - Psychosom Med VL - 76 IS - 2 N2 - Background Panic disorder (PD) is a common anxiety disorder among asthmatic patients with overlapping symptoms (e.g., hyperventilation). However, the longitudinal impact of PD on asthma control remains poorly understood. This study assessed the impact of PD and panic-anxiety on asthma control over a 4.3-year follow-up in 643 adult asthmatic patients. Methods Consecutive patients presenting to a tertiary asthma clinic underwent a sociodemographic, medical history, and psychiatric (Primary Care Evaluation of Mental Disorders) interview and completed questionnaires including the Anxiety Sensitivity Index (ASI) to assess panic-anxiety. At follow-up, patients completed the Asthma Control (ACQ) and Asthma Quality of Life (AQLQ) questionnaires and reported emergency department visits and hospitalizations during the follow-up. Results Baseline frequency of PD was 10% (n = 65). In fully adjusted models, analyses revealed that PD and ASI scores predicted worse follow-up ACQ total scores (β = 0.292, p = .037; β = 0.012, p = .003) but not AQLQ total scores. ASI scores also predicted greater nocturnal and waking symptoms, activity limitations, and bronchodilator use on the ACQ (β = 0.012-0.018, p < .05) as well as lower symptom (β = -0.012, p = .006) and emotional distress (β = -0.014, p = .002) subscale scores on the AQLQ. Neither PD nor ASI scores were associated with hospitalizations, although ASI scores (but not PD) were associated with an increased risk of emergency department visits (relative risk = 1.023, 95% confidence interval = 1.001-1.044). Conclusions PD and anxiety sensitivity are prospectively associated with poorer asthma control and may be important targets for treatment. SN - 1534-7796 UR - https://www.unboundmedicine.com/medline/citation/24470131/Prospective_impact_of_panic_disorder_and_panic_anxiety_on_asthma_control_health_service_use_and_quality_of_life_in_adult_patients_with_asthma_over_a_4_year_follow_up_ L2 - http://dx.doi.org/10.1097/PSY.0000000000000032 DB - PRIME DP - Unbound Medicine ER -