Impact of interventions targeting anxiety and depression in adults with asthma

Abstract

Objective

High rates of anxiety and depression exist among asthma patient populations. This scoping review will examine the existing interventional therapies that address depression and anxiety symptoms in patients with asthma.

Data Sources

PubMed, Cochrane, Psychinfo, CINAHL, Google Scholar and EMBASE databases were searched using the following search terms: ‘anxiety asthma’, ‘panic disorder asthma’ and ‘depression asthma’ with a randomized clinical trial filter and additional filters to exclude exclusion criteria.

Study Selections

Study selections included only randomized control trials with anxiety and/or depression and/or panic disorder outcomes as primary or secondary outcomes. Only full-text articles in the English language were included.

Results

This search yielded interventions from pharmacologic (n = 3), psychological (n = 7), lifestyle medicine (n = 10) and complementary and alternative medicine (CAM; n = 1) using a range of outcomes from physiologic to psychologic. While the pharmacologic and CAM studies were inconclusive, psychologic and lifestyle interventions showed improvements in asthma (quality of life, symptoms, asthma attacks) and psychological (anxiety, panic fear, depression) outcomes. Variations in selection methods, outcome measures and diagnostic criteria hindered a direct comparison of the studies. Most studies had small sample sizes, high attrition rates and short study durations.

Conclusion

There is limited evidence on best approaches for managing co-morbid anxiety and/or depression in patients with asthma. Psychological and lifestyle medicine interventions are promising with improvements in both asthma and mental health outcomes. Well-designed randomized controlled studies with larger sample sizes, standardized outcomes and longer durations, are needed to better understand the role of depression and anxiety in adults with asthma.

Keywords:

• Asthma
• depression
• anxiety
• antidepressants
• psychotherapy
• cognitive behavior therapy
• lifestyle medicine
• panic disorder
• complementary and alternative medicine

Acknowledgement

We would like to thank Valentin Prieto-Centurion for his assistance in planning the manuscript.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

The project as supported by NHLBI K01 HL 133370.