MedWire News: Patient-reported depressive symptoms are more closely tied with asthma control than are physician-reported depressive disorders, researchers report.
Most patients receive their asthma and mental healthcare from primary care physicians, making physician diagnoses critical for the treatment of both conditions, say the researchers.
In a cross-sectional analysis, they assessed patient- and physician-reported depressive conditions relating to asthma severity and control in 257 patients with mild-intermittent to moderate-persistent asthma.
Asthma severity referred to the long-term nature of asthma as a chronic illness, whereas asthma control referred to its short-term nature and potential to wax and wane.
Patient-reported depressive symptoms were determined using the Geriatric Depression Scale (GDS), report Carol Mancuso (Hospital for Special Surgery, New York) and colleagues in the journal Chest.
Physician-reported depressive disorders were identified from a depression diagnosis in patients, depressive symptoms described in medical charts, or antidepressant prescriptions at doses used to treat depression.
Patients also completed the Severity of Asthma Scale (SOA), and the Asthma Control Questionnaire (ACQ).
Mean SOA was 5.9 out of a possible 28, mean ACQ score was 1.4 out of 6, and mean GDS score was 6.3 from a possible 30. Increasing scores indicated more severe asthma, worse control of asthma, and more severe depression, respectively.
Both patient-reported depressive symptoms and physician-reported depressive disorders were significantly associated with asthma severity, but only patient reports were associated with asthma control.
The researchers speculate that this may be because asthma severity measurements encompassed the past year, overlapping with the period in which physician diagnoses were made, whereas control examined symptoms and limitations in the preceding week.
"This finding is important because it leads to the hypothesis that long-standing depressive conditions may not be as critical to asthma control as are short-term depressive symptoms," they say.