Depression and Anxiety in Adult Patients with Asthma

Abstract

Asthma is a public health problem because of increasing prevalence in children and older adults. It is estimated that over three hundred million people are living with asthma worldwide. The high burden of asthma is associated with greater functional impairment and increased healthcare utilization in older adults. This chapter examines the impact of depression and anxiety and its management in older adults with asthma. Depression and anxiety are common comorbidities in older adults with asthma. They are associated with poor asthma control, low self-esteem, acute exacerbation, frequent episodes of hospital admission, poor adherence to medical treatment, impaired quality of life and suicidal ideation. The efficacy pulmonary rehabilitation (PR), cognitive behavioural therapy (CBT) and antidepressant drug therapy for patients with depression and anxiety in asthma are explored. Our findings indicate that PR and CBT are beneficial in improving depressive and anxiety symptoms and quality of life in short-term uncontrolled intervention studies. However, the long-term efficacy of CBT and PR is unknown. To date, the efficacy of antidepressant drug therapy for depression and anxiety in patients with COPD and asthma is uncertain. Thus, healthcare professionals should devise strategies to detect anxiety and depressive symptoms in older adults with asthma and offer appropriate treatment to reduce disease burden and improve quality of life. Well-controlled randomized trials are needed to examine the efficacy of intervention with long-term follow-up.