Clinical findings associated with depression in a patient with asthma:
(1) severe asthma (with significant dyspnea, fatigue and/or hypoxemia)
(2) difficult-to-control or brittle asthma
(3) severe disability
(4) poor self-rated health
(5) moderate to severe anxiety
(6) history of depression
(7) cigarette smoking or substance abuse
(8) anger
(09) poor adherence to therapeutic regimen
(10) no or limited social support
(11) poor sleep quality
(12) poor appetite
(13) high dose corticosteroids
Impact of depression for a patient with asthma:
(1) poor quality of life
(2) poor compliance
(3) delays in seeking assistance during an exacerbation
(4) increased ED visits and/or hospitalizations
(5) increased likelihood of smoking and substance abuse
(6) sudden death
Treatment of depression can significantly improve the level of asthma control and the patient's quality of life. Care must be taken to avoid adverse drug effects and drug interactions associated with polypharmacy.
