Abstract
BackgroundPrevious studies have suggested that asthmatic patients often have comorbid depression; however, temporal associations remain unclear.ObjectivesTo determine whether depression predicts asthma and, conversely, whether asthma predicts depression.MethodsA literature search was conducted without language restrictions using Pubmed, Embase, Cochrane and PsycINFO for studies published before January, 2015. Papers referenced by the obtained articles were also reviewed. Only comparative prospective studies with reported risk estimates of the association between depression and asthma were included. In order to investigate whether one of these conditions was predictive of the other, studies were excluded if enrolled participants had pre-existing depression or asthma. A random-effects model was used to calculate the pooled risk estimates for two outcomes: depression predicting asthma and asthma predicting depression.ResultsSeven citations, derived from 8 cohort studies, met our inclusion criteria. Of these, six studies reported that depression predicted incident adult-onset asthma, including 83684 participants and 2334 incident cases followed for 8 to 20 years. Conversely, two studies reported that asthma predicted incident depression. These studies involved 25566 participants and 2655 incident cases followed for 10 and 20 years, respectively. The pooled adjusted relative risks (RRs) of acquiring asthma associated with baseline depression was 1.43 (95% CI, 1.28–1.61) (P<0.001). The adjusted RRs for acquiring depression associated with baseline asthma was 1.23 (95% CI, 0.72–2.10) (P = 0.45).ConclusionsDepression was associated with a 43% increased risk of developing adult-onset asthma. However, asthma did not increase the risk of depression based on limited studies. Further prospective studies ascertaining the true association between asthma and subsequent risk of depression are warranted.
Highlights
Depression and asthma are two highly prevalent chronic diseases in the United States and worldwide, imposing unacceptable social and economic burdens on the public healthcare system [1,2]
Six studies reported that depression predicted incident adult-onset asthma, including 83684 participants and 2334 incident cases followed for 8 to 20 years
Two studies reported that asthma predicted incident depression
Summary
Depression and asthma are two highly prevalent chronic diseases in the United States and worldwide, imposing unacceptable social and economic burdens on the public healthcare system [1,2]. Asthma affects 39.5 million Americans, 29.0 million of which are adults, and 300 million individuals worldwide [4], with increasing prevalence in many countries [5]. Because both depression and asthma impose substantial public health burdens, the association between these two conditions has attracted attention over the past several decades. A previous meta-analysis of prospective studies [6] reported a bidirectional relationship between psychosocial factors and atopic disorders. Previous studies have suggested that asthmatic patients often have comorbid depression; temporal associations remain unclear
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