Resumen
Antecedentes: El nivel de control del asma en países latinoamericanos sigue siendo pobre y no alcanza los objetivos establecidos por las guías internacionales. Las razones son desconocidas.
Objetivo: Explorar la frecuencia de ansiedad y depresión en los pacientes con asma y sus posibles asociaciones en el control del asma.
Métodos: Estudio transversal en pacientes con asma en Guayaquil, Ecuador. Se empleó chi cuadrada para evaluar la asociación entre ansiedad o depresión y las variables demográficas. Se valoró la correlación entre la prueba de control de asma y la escala hospitalaria de ansiedad y depresión mediante tau-b de Kendall.
Resultados: De 73 pacientes, 55 (80.9%) eran mujeres y 50 (69.4%) tenían nivel educativo bajo; 49 (67.1%) tuvieron asma no controlada (p = 0.005). Pocos pacientes presentaron síntomas de ansiedad (2.7%) y depresión (1.4%) (p = 0.000). Los factores asociados con mayor proporción de ansiedad y depresión fueron edad ≤ 60 años, sexo femenino y asma no controlada. No hubo correlación significativa entre el control del asma y la puntuación de ansiedad o depresión.
Conclusión: Numerosos pacientes asmáticos no tienen control adecuado de su enfermedad y los trastornos de ansiedad o depresión parecen influir poco en el control de la enfermedad.
Referencias
Cruz AA, Stelmach R, Ponte EV. Asthma prevalence and severity in low-resource communities. Curr Opin Allergy Clin Immunol. 2017;17(3):188-193. DOI: 10.1097/ACI.0000000000000360
Masoli M, Fabian D, Holt S, Beasley R, Global Initiative for Asthma (GINA) Program. The global burden of asthma: executive summary of the GINA Dissemination Committee Report. Allergy. 2004;59(5):469-478. DOI: 10.1111/j.1398-9995.2004.00526.x
Solé D, Sánchez-Aranda C, Falbo-Wandalsen G. Asthma: epidemiology of disease control in Latin America-short review. Asthma Res Pract. 2017;3:4. DOI: 10.1186/s40733-017-0032-3
Luyster FS, Teodorescu M, Bleecker E, Busse W, Calhoun W, Castro M, et al. Sleep quality and asthma control and quality of life in non-severe and severe asthma. Sleep Breath. 2012;16(4):1129-1137. DOI: 10.1007/s11325-011-0616-8
Braido F. Failure in asthma control: reasons and consequences. Scientifica (Cairo). 2013;2013:549252. DOI: 10.1155/2013/549252
Neffen H, Chahuan M, Hernández DD, Vallejo-Pérez E, Bolívar F, Sánchez MH, et al. Key factors associated with uncontrolled asthma - the Asthma Control in Latin America Study. J Asthma. 2019:1-10. DOI: 10.1080/02770903.2018.1553050
Lomper K, Chudiak A, Uchmanowicz I, Rosinczuk J, Jankowska-Polanska B. Effects of depression and anxiety on asthma-related quality of life. Pneumonol Alerol Pol. 2016;84(4):212-221. DOI: 10.5603/PiAP.2016.0026
Labor M, Labor S, Juric I, Fijacko V, Popovic GS, Plavec D. Long-term predictors of anxiety and depression in adult patients with asthma. Wien Klin Wochenschr. 2017;129(19-20):665-673. DOI: 10.1007/s00508-017-1203-1
Lu Y, Mak KK, Van Bever HP, Ng TP, Mak A, Ho RC. Prevalence of anxiety and depressive symptoms in adolescents with asthma: a meta-analysis and meta-regression. Pediatric Allergy Immunol. 2012;23(8):707-715. DOI: 10.1111/pai.12000
Labor S, Labor M, Juric I, Vuksic Z. The prevalence and pulmonary consequences of anxiety and depressive disorders in patients with asthma. Coll Antropol. 2012;36(2):473-481.
Nogueira KT, Silva JR, Lopes CS. Quality of life of asthmatic adolescents: assessment of asthma severity, comorbidity, and life style. J Pediatr (Rio J). 2009;85(6):523-530. DOI: 10.2223/JPED.1957
Herrero MJ, Blanch J, Peri JM, De Pablo J, Pintor L, Bulbena A. A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population. Gen Hosp Psychiatry. 2003;25(4):277-283. DOI: 10.1016/S0163-8343(03)00043-4
Vega JM, Badia X, Badiola C, López-Viña A, Olaguíbel JM, Picado C, et al. Validation of the Spanish version of the Asthma Control Test (ACT). J Asthma. 2007;44(10):867-872. DOI: 10.1080/02770900701752615
Hekking PP, Amelink M, Wener RR, Bouvy ML, Bel EH. Comorbidities in difficult-to-control asthma. J Allergy Clin Immunol Pract. 2018;6(1):108-113. DOI: 10.1016/j.jaip.2017.06.008
Scott KM, Von Korff M, Ormel J, Zhang MY, Bruffaerts R, Alonso J, et al. Mental disorders among adults with asthma: results from the World Mental Health Survey. Gen Hosp Psychiatry. 2007;29(2):123-133. DOI: 10.1016/j.genhosppsych.2006.12.006
Ciprandi G, Schiavetti I, Rindone E, Ricciardolo FL. The impact of anxiety and depression on outpatients with asthma. Ann Allergy Asthma Immunol. 2015;115(5):408-414. DOI: 10.1016/j.anai.2015.08.007
Liu S, Wu R, Li L, Liu L, Li G, Zhang X, et al. The prevalence of anxiety and depression in Chinese asthma patients. PloS One. 2014;9(7):e103014. DOI: 10.1371/journal.pone.0103014
Vieira AA, Santoro IL, Dracoulakis S, Caetano LB, Fernandes AL. Anxiety and depression in asthma patients: impact on asthma control. J Bras Pneumol. 2011;37(1):13-18. DOI: 10.1590/s1806-37132011000100004
Sundbom F, Malinovschi A, Lindberg E, Alving K, Janson C. Effects of poor asthma control, insomnia, anxiety and depression on quality of life in young asthmatics. J Asthma. 2016;53(4):398-403. DOI: 10.3109/02770903.2015.1126846
Temprano J, Mannino DM. The effect of sex on asthma control from the National Asthma Survey. J Allergy Clin Immunol. 2009;123(4):854-860. DOI: 10.1016/j.jaci.2008.12.009
Osborne ML, Vollmer WM, Linton KL, Buist AS. Characteristics of patients with asthma within a large HMO: a comparison by age and gender. Am J Respir Crit Care Med. 1998;157(1):123-128. DOI: 10.1164/ajrccm.157.1.9612063
Di Marco F, Verga M, Santus P, Giovannelli F, Busatto P, Neri M, et al. Close correlation between anxiety, depression, and asthma control. Respir Med. 2010;104(1):22-28. DOI: 10.1016/j.rmed.2009.08.005
Frieri M, O’Connor M, Nassef M. Asthma, stress, and depression in women. Allergy Asthma Proc. 2015;36(4):256-261. DOI: 10.2500/aap.2015.36.3847
Mbatchou-Ngahane BH, Pefura-Yone EW, Mama M, Nganda-Motto M, Olinga U, Wandji A, et al. Assessment of asthma control using asthma control test in chest clinics in Cameroon: a cross-sectional study. Pan Afr Med J. 2016;23:70. DOI: 10.11604/pamj.2016.23.70.8434
Yildiz F, ASIT Study Group. Factors influencing asthma control: results of a real-life prospective observational asthma inhaler treatment (ASIT) study. J Asthma Allergy. 2013;6:93-101. DOI: 10.2147/JAA.S45269
Bjelland I, Krokstad S, Mykletun A, Dahl AA, Tell GS, Tambs K. Does a higher educational level protect against anxiety and depression? The HUNT Study. Soc Sci Med. 2008;66(6):1334-145. DOI: 10.1016/j.socscimed.2007.12.019
Ludermir AB, Lewis G. Links between social class and common mental disorders in Northeast Brazil. Soc Psychiatry Psychiatr Epidemiol. 2001;36(3):101-107. DOI: 10.1007/s001270050297
Araya R, Lewis G, Rojas G, Fritsch R. Education and income: which is more important for mental health? J Epidemiol Community Health. 2003;57(7):501-505. DOI: 10.1136/jech.57.7.501
Koenig HG, George LK, Peterson BL. Religiosity and remission of depression in medically ill older patients. Am J Psychiatry. 1998;155(4):536-542. DOI: 10.1176/ajp.155.4.536
Smith TB, McCullough ME, Poll J. Religiousness and depression: evidence for a main effect and the moderating influence of stressful life events. Psychol Bull. 2003;129(4):614-636. DOI: 10.1037/0033-2909.129.4.614
Ahmedani BK, Peterson EL, Wells KE, Rand CS, Williams LK. Asthma medication adherence: the role of God and other health locus of control factors. Ann Allergy Asthma Immunol. 2013;110(2):75-79. DOI: 10.1016/j.anai.2012.11.006
Braam AW, Beekman AT, Deeg DJ, Smit JH, Van Tilburg W. Religiosity as a protective or prognostic factor of depression in later life; results from a community survey in The Netherlands. Acta Psychiatr Scand. 1997;96(3):199-205. DOI: 10.1111/j.1600-0447.1997.tb10152.x
Kendler KS, Thornton LM, Gardner CO. Genetic risk, number of previous depressive episodes, and stressful life events in predicting onset of major depression. Am J Psychiatry. 2001;158(4):582-586. DOI: 10.1176/appi.ajp.158.4.582
Schieman S. The education-contingent association between religiosity and health: the differential effects of self-esteem and the sense of mastery. J Sci Study Relig. 2008;47(4):710-724. DOI: 10.1111/j.1468-5906.2008.00436.x
Instituto Nacional de Estadística y Censo [sitio web]. INEC presenta por primera vez estadísticas sobre religión. Costa Rica: Instituto Nacional de Estadística y Censos; 2012. Disponible en: http://www.ecuadorencifras.gob.ec/inec-presenta-por-primera-vez-estadisticas-sobre-religion/
Labor M, Labor S, Juric I, Fijacko V, Grle SP, Plavec D. Mood disorders in adult asthma phenotypes. J Asthma. 2018;55(1):57-65. DOI: 10.1080/02770903.2017.1306546
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
Derechos de autor 2019 Revista Alergia México