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      The relationship between allergy and asthma control, quality of life, and emotional status in patients with asthma: a cross-sectional study

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          Abstract

          Background

          Psychiatric comorbidities are prevalent in patients with chronic somatic disorders such as asthma. But, there is no clear evidence regarding the effect of atopic status and the type of sensitized allergen on emotional status. The aim of the present study was to investigate the effects of house dust mites and pollen allergies on emotional status, asthma control and the quality of life in patients with atopic asthma.

          Methods

          The study included 174 consecutive patients who were diagnosed with asthma accoring to the GINA criteria and who did not receive therapy for their allergy. All patients underwent a skin prick test. The asthma control, quality of life, and emotional status were evaluated using the ACT (asthma control test), AQLQ (asthma-specific quality of life questionnaire), and HAD (hospital anxiety depression questionnaire).

          Results

          Atopy was detected in 134 (78.7%) patients. Of those patients: 58 (33.3%) had anxiety and 83 (47.7%) had depression. There was no relationship between emotional status, atopic status, and the type of indoor/outdoor allergen. Furthermore, there was no relationship between atopy and asthma severity, asthma control, and the quality of life. The anxiety and depression scores were significantly higher and the quality of life scores lower in the uncontrolled asthma group. The ACT and AQLQ scores were also lower in the anxiety and depression groups.

          Conclusions

          It was concluded that anxiety and depression are prevalent in patients with uncontrolled asthma, and atopic status did not affect the scores in ACT, AQLQ, and emotional status tests.

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          Most cited references34

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          Beyond atopy: multiple patterns of sensitization in relation to asthma in a birth cohort study.

          The pattern of IgE response (over time or to specific allergens) may reflect different atopic vulnerabilities which are related to the presence of asthma in a fundamentally different way from current definition of atopy. To redefine the atopic phenotype by identifying latent structure within a complex dataset, taking into account the timing and type of sensitization to specific allergens, and relating these novel phenotypes to asthma. In a population-based birth cohort in which multiple skin and IgE tests have been taken throughout childhood, we used a machine learning approach to cluster children into multiple atopic classes in an unsupervised way. We then investigated the relation between these classes and asthma (symptoms, hospitalizations, lung function and airway reactivity). A five-class model indicated a complex latent structure, in which children with atopic vulnerability were clustered into four distinct classes (Multiple Early [112/1053, 10.6%]; Multiple Late [171/1053, 16.2%]; Dust Mite [47/1053, 4.5%]; and Non-dust Mite [100/1053, 9.5%]), with a fifth class describing children with No Latent Vulnerability (623/1053, 59.2%). The association with asthma was considerably stronger for Multiple Early compared with other classes and conventionally defined atopy (odds ratio [95% CI]: 29.3 [11.1-77.2] versus 12.4 [4.8-32.2] versus 11.6 [4.8-27.9] for Multiple Early class versus Ever Atopic versus Atopic age 8). Lung function and airway reactivity were significantly poorer among children in Multiple Early class. Cox regression demonstrated a highly significant increase in risk of hospital admissions for wheeze/asthma after age 3 yr only among children in the Multiple Early class (HR 9.2 [3.5-24.0], P < 0.001). IgE antibody responses do not reflect a single phenotype of atopy, but several different atopic vulnerabilities which differ in their relation with asthma presence and severity.
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            Global strategy for asthma management and prevention

            (2014)
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              Close correlation between anxiety, depression, and asthma control.

              We investigated the correlation between patients' characteristics, including anxiety and depression, and the level of asthma control evaluated by asthma control test (ACT), a self-administered validated questionnaire. This is a cross-sectional study on asthmatic outpatients of three Italian hospitals. Demographic data, spirometry, anxiety and depression scores as well as the level of asthma control from 315 patients were collected. Patients with poorly controlled asthma were more frequently women, older, with a worse pulmonary function, obese, more anxious and/or more depressed. Four different independent factors associated with poor asthma control evaluated by ACT have been found: FEV(1) or =65 years (OR: 2.69), and depression (OR: 2.45). The presence of anxiety and depression was associated with a higher healthcare utilization. Finally, we found a high level of agreement between ACT and multidimensional GINA approach in evaluating asthma control, with a concordance in 239 patients (81% of the population). There is a close correlation between anxiety and depression, and a poor asthma. A better understanding of this association may have major clinical implications, mainly in patients with poor controlled asthma in whom the presence of anxiety and depression should be investigated. Copyright 2009 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                hikmetcoban04@gmail.com
                dryaydemir@yahoo.com
                Journal
                Allergy Asthma Clin Immunol
                Allergy Asthma Clin Immunol
                Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology
                BioMed Central (London )
                1710-1484
                1710-1492
                21 December 2014
                21 December 2014
                2014
                : 10
                : 1
                : 67
                Affiliations
                [ ]Department of Pulmonology, Sakarya University, Sakarya, Turkey
                [ ]Training and Research Hospital, Sakarya University, 54100 Sakarya, Turkey
                Article
                67
                10.1186/s13223-014-0067-4
                4311476
                25642249
                33a88d45-7102-406b-a05b-400fb3b873a5
                © Çoban and Aydemir; licensee BioMed Central. 2014

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 29 September 2014
                : 11 December 2014
                Categories
                Research
                Custom metadata
                © The Author(s) 2014

                Immunology
                atopy,asthma control,quality of life,emotional status,depression,anxiety
                Immunology
                atopy, asthma control, quality of life, emotional status, depression, anxiety

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