Psychiatric disorders and asthma outcomes among high-risk inner-city patients

Jonathan M. Feldman, Mahmood I. Siddique, Enid Morales, Beverly Kaminski, Shou En Lu, Paul M. Lehrer

Research output: Contribution to journalArticlepeer-review

72 Scopus citations

Abstract

Objective: The purpose of this study was to examine the rate of psychiatric disorders among patients attending an ethnically diverse, inner-city asthma clinic for an initial visit and assess the association between psychiatric disorders and asthma morbidity. Methods: A semistructured psychological interview was conducted to assess for psychiatric diagnoses. A pulmonary physician, who was blind to psychiatric disorder, established diagnosis of asthma based on national guidelines. Results: Sixty-four percent of 85 participants received at least 1 psychiatric diagnosis. The pulmonary physician rated patients with a psychiatric disorder as achieving fewer goals (M = 2.3 ± 1.3) for asthma control than patients without a psychiatric disorder (M = 3.6 ± 1.5, p = .0002). Patients with a psychiatric diagnosis more frequently reported an emergency room visit for asthma during the past 6 months (OR = 4.89; 95% CI, 1.76-13.39) and greater use of short-acting β2-agonist medication (M = 1.5 ± 0.9 canisters per month) than patients without a psychiatric diagnosis (M = 0.9 ± 0.8, p = .003). These findings were independent of demographics, health insurance, and asthma severity. No differences emerged between patients with and without a mental disorder on percent predicted FEV1. Patients with a psychiatric disorder reported a higher severity level for asthma symptoms than the severity level indicated by their pulmonary function in comparison to patients without a psychiatric diagnosis (OR = 3.52; 95% CI, 1.23-10.10). Health insurance appeared to be a confounding factor in this relationship. Conclusion: A high rate of psychiatric disorders was found among inner-city asthma patients. Psychiatric diagnoses were associated with greater perceived impairment from asthma but not objective measurement of pulmonary function.

Original languageEnglish (US)
Pages (from-to)989-996
Number of pages8
JournalPsychosomatic Medicine
Volume67
Issue number6
DOIs
StatePublished - Nov 2005

All Science Journal Classification (ASJC) codes

  • Applied Psychology
  • Psychiatry and Mental health

Keywords

  • Asthma
  • Health-care-seeking behavior
  • Mental disorders
  • Quality of life

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