D1.113 - Severe Asthma and Depression: the Overlooked Burden

Severe asthma is a challenging condition that often impair patients’ physical and emotional well-being. Depression is a common comorbidity in chronic diseases that compound the burden faced by those patients. However, its impact on severe asthma remains underexplored. This study aims to characterize the frequency of depression on severe asthma patients and its association with the degree of asthma control.

Observational, cross-sectional study including severe asthma patients (children and adults) followed at the Allergy and Clinical Immunology department of a tertiary hospital. Data were collected using a standardized questionnaire and clinical records. Informed consent was provided by all participants. Sociodemographic data, body mass index (BMI), Asthma Control Test (ACT) and fractional nitric oxide concentration in exhaled breath (FeNO) were considered. Depression was assessed using the Beck Depression Inventory-II (BDI-II) (≥13 years) and the Children’s Depression Inventory (CDI) (<13 years), with severe depression defined as scores above 28 and 24, respectively. A p-value below 0.05 was considered statistically significant.

Among the 57 patients, 39 (68.4%) were female. The median age was 33.16 years (range: 7–71), with a median BMI of 23.94 (IQR 11.96) and a median FeNO of 24.00 (IQR 26.50). Based on BDI-II and CDI scores depression was identified in 26 patients (45.6%). Among adults and adolescents with depression (n=23, 53.5%), 5 (11.6%) had mild, 11 (25.6%) moderate, and 7 (16.3%) severe symptoms. Of the younger children (<13 years) with depression (n=3, 21.4%), 1 (7.1%) had mild and 2 (14.3%) moderate symptoms.  Patients with severe depression had lower ACT scores (median: 17.00 vs. 10.50, p = 0.001) and more short-term systemic corticosteroid (SCS) cycles (median: 1.00 vs. 4.00, p = 0.009). No significant differences were observed between groups for age (p = 0.082), BMI (p = 0.161), or FeNO levels (p = 0.967).

This study highlights the high prevalence of depression among patients with severe asthma, regardless of age, emphasizing the significant emotional burden these individuals face. Worse symptom control and more SCS cycles seems to be associated with severe depression. These findings underscore the need for integrated care strategies addressing both asthma and mental health to improve patients' quality of life.