Prospective Impact of Panic Disorder and Panic-Anxiety on Asthma Control, Health Service Use, and Quality of Life in Adult Patients With Asthma Over a 4-Year Follow-Up
Abstract
Background Panic disorder (PD) is a common anxiety disorder among asthmatic patients with overlapping symptoms (e.g., hyperventilation). However, the longitudinal impact of PD on asthma control remains poorly understood. This study assessed the impact of PD and panic-anxiety on asthma control over a 4.3-year follow-up in 643 adult asthmatic patients. Methods Consecutive patients presenting to a tertiary asthma clinic underwent a sociodemographic, medical history, and psychiatric (Primary Care Evaluation of Mental Disorders) interview and completed questionnaires including the Anxiety Sensitivity Index (ASI) to assess panic-anxiety. At follow-up, patients completed the Asthma Control (ACQ) and Asthma Quality of Life (AQLQ) questionnaires and reported emergency department visits and hospitalizations during the follow-up. Results Baseline frequency of PD was 10% (n = 65). In fully adjusted models, analyses revealed that PD and ASI scores predicted worse follow-up ACQ total scores (β = 0.292, p = .037; β = 0.012, p = .003) but not AQLQ total scores. ASI scores also predicted greater nocturnal and waking symptoms, activity limitations, and bronchodilator use on the ACQ (β = 0.012-0.018, p < .05) as well as lower symptom (β = -0.012, p = .006) and emotional distress (β = -0.014, p = .002) subscale scores on the AQLQ. Neither PD nor ASI scores were associated with hospitalizations, although ASI scores (but not PD) were associated with an increased risk of emergency department visits (relative risk = 1.023, 95% confidence interval = 1.001-1.044). Conclusions PD and anxiety sensitivity are prospectively associated with poorer asthma control and may be important targets for treatment.
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- Authors
- Favreau, H., Bacon, S. L., Labrecque, M., & Lavoie, K. L.
- Affiliations
- Université du Québec à Montréal (CA)
- Corresponding author
- Lavoie, Kim L.
- Venue
- Psychosomatic Medicine
- Published
- 2014-02
- Volume
- 76
- Issue
- 2
- Pages
- 147-155
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W2335100178
- Cited by
- 63
- References
- 48
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 5 · 2022: 4 · 2020: 7 · 2019: 8 · 2018: 4 · 2017: 10 · 2016: 7 · 2015: 4 · 2014: 3
- FWCI
- 5.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- panic disorder, panic anxiety, anxiety sensitivity, asthma control, asthma quality of life, health care utilization, emergency department visits, hospitalization, adult asthma, psychosomatic comorbidity, hyperventilation
- MeSH terms
- Adult, Ambulatory Care, Anxiety, Asthma, Bronchodilator Agents, Emergency Service, Hospital, Fear, Female, Follow-Up Studies, Hospitalization, Humans, Interview, Psychological, Male, Middle Aged, Patient Acceptance of Health Care, Quality of Life, Surveys and Questionnaires, Regression Analysis, Stress, Psychological, Panic Disorder
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