Clinical Summary

Asthma, Atopic Dermatitis Linked to Increased Risk of Depression and Anxiety

Sarfaroj Khan

Takeaway

Asthma and atopic dermatitis (AD) were associated with an increased risk of depression and anxiety.
Middle-age onset (40-59 years) presented the strongest associations with depression and anxiety.
A dose-response association was observed between neutrophil-to-lymphocyte ratio (NLR) with depression and anxiety.

Why this matters

NLR may represent a potential marker to differentiate among patients with asthma or AD at intermediate or high risk of depression and anxiety symptomatology (DAS).

Study design

This study used cross-sectional data of 502,641 participants (age, 40-69 years) from the UK Biobank during 2006-2010.
NLR of patients with asthma and AD was evaluated in relation to DAS, assessed using the Patient Health Questionnaire-4 (PHQ-4).
Funding: National Institute for Health Research Biomedical Research Centre at South London and others.

Key results

The prevalence of DAS was 11.7% and 2.7% among participants diagnosed with asthma (n=58,833) and AD (n=13,462), respectively.
PHQ-4 score increased in patients with asthma (β=0.36; 95% CI, 0.34-0.38) and AD (β=0.15; 95% CI, 0.10-0.19) with highest increment observed in patients having both (β=0.41; 95% CI, 0.34-0.49).
A gradual increment in PHQ-4 score was seen in patients with asthma with higher NLR tertiles:
- tertile 1 (β=0.30; 95% CI, 0.27-0.34);
- tertile 2 (β=0.36; 95% CI, 0.32-0.39); and
- tertile 3 (β=0.43; 95% CI, 0.39-0.46).
An inverted U-shaped association was observed between the age of asthma onset and PHQ-4 score; DAS risk was highest in the age group “40-59” (β=0.54; 95% CI, 0.48-0.59), followed by “60 and above” (β=0.43; 95% CI, 0.34-0.51) and “20-39” (β=0.32; 95% CI, 0.27-0.38) age groups.
Similar patterns were seen in patients with AD.

Limitations