Asthma and mental disorders in primary care

• Published in: General hospital psychiatry 2003-11, Vol.25 (6), p.479-483
• Main Authors: Goodwin, Renee D., Olfson, Mark, Shea, Steven, Lantigua, Rafael A., Carrasquilo, Olveen, Gameroff, Marc J., Weissman, Myrna M.
• Format: Article
• Language: English
• Subjects: Academic Medical Centers; Adolescent; Adult; Adult and adolescent clinical studies; Aged; Alcoholism - diagnosis; Alcoholism - epidemiology; Alcoholism - therapy; Anxiety Disorders - diagnosis; Anxiety Disorders - epidemiology; Anxiety Disorders - therapy; Asthma - epidemiology; Asthma - psychology; Biological and medical sciences; Chronic obstructive pulmonary disease, asthma; Comorbidity; Cross-Sectional Studies; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - therapy; Female; Humans; Internal Medicine - statistics & numerical data; Likelihood Functions; Male; Medical sciences; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Mental Disorders - therapy; Middle Aged; Miscellaneous; New York City; Panic Disorder - diagnosis; Panic Disorder - epidemiology; Panic Disorder - therapy; Pneumology; Primary Health Care - statistics & numerical data; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Substance-Related Disorders - diagnosis; Substance-Related Disorders - epidemiology; Substance-Related Disorders - therapy; Suicide, Attempted - prevention & control; Suicide, Attempted - psychology; Suicide, Attempted - statistics & numerical data; Urban Population - statistics & numerical data
• ISSN: 0163-8343; 1873-7714
• DOI: 10.1016/S0163-8343(03)00071-9

This study examines relationships between asthma and likelihood of current mental disorders and suicidal ideation in an urban primary care population. A systematic waiting room sample of 998 adult patients was screened for mental disorders using the PRIME-MD PHQ. Asthma diagnoses were provided by primary care physicians. Multivariate logistic regression analyses were used to determine the odds of current major depression, panic attacks, generalized anxiety disorder, alcohol and drug use disorder, and suicidal ideation among patients with a diagnosis of asthma, as compared to those without asthma. After controlling for differences in sociodemographic characteristics and comorbid mental disorders, asthma was associated with increased likelihood of panic attack (OR=1.7 (1.1, 2.6)) and suicidal ideation (OR=1.9 (1.03, 3.4)). There was no statistically significant association between asthma and major depression, generalized anxiety disorder, alcohol, or drug use disorders after adjustment. Results suggest that physician-diagnosed asthma is associated with self-reported panic attacks and suicidal ideation in a systematic sample of primary care patients. Physicians who treat patients with asthma should remain vigilant for the presence of comorbid psychiatric problems and carefully evaluate whether there is a clinical need to treat each condition.