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Anxiety in asthma: a systematic review and meta-analysis

Published online by Cambridge University Press:  12 January 2021

Gang Ye ,
David S. Baldwin  and
Ruihua Hou Open the ORCID record for Ruihua Hou [Opens in a new window]
Gang Ye
Affiliation:
Suzhou Guangji Hospital, Suzhou, Jiangsu, China
David S. Baldwin
Affiliation:
Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
Ruihua Hou*
Affiliation:
Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK
*
Author for correspondence: Ruihua Hou, E-mail: [email protected]
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Abstract

Background

Background: Growing evidence from observational studies indicates a high prevalence of anxiety in asthma. However, prevalence rates of coexisting anxiety symptoms and comorbid anxiety disorders vary widely across studies. We aimed to evaluate the associations between anxiety and asthma and provide more precise comorbidity estimates.

Methods

We systematically reviewed the literature from case-controlled studies and conducted a meta-analysis to evaluate the pooled prevalence estimates and risks of anxiety symptoms and anxiety disorders in asthma individuals. Screening, data extraction, and quality assessment were undertaken following PRISMA guidelines for preferred reporting of systematic reviews and meta-analysis. A random-effects model was used to calculate pooled prevalence rates. Meta-analysis was conducted using Review Manager 5.3. Multiple databases including PubMed, ScienceDirect, PsychINFO, and PsycARTICLES were searched for publications before 1 December 2019. The review protocol was registered on PROSPERO (ref: CRD42020176028).

Results

In total, 19 studies involving 106813 participants were included. The pooled prevalence of anxiety symptoms and anxiety disorders in individuals with asthma was 0.32 (95% CI 0.22–0.43) and 0.24 (95% CI 0.13–0.41), respectively. The risks of coexisting anxiety symptoms and comorbid anxiety disorders were significantly higher in asthma patients than in non-asthma controls indicated by OR 1.89 (95% CI 1.42–2.52; Z = 4.37; p < 0.001) and OR 2.08 (95% CI 1.70–2.56; Z = 6.97; p < 0.001), respectively. Anxiety symptoms and anxiety disorders occur at increased frequency among patients with asthma.

Conclusions

Our findings highlight the need for appropriate assessments for these comorbid conditions, which may help to identify a subgroup of patients who might benefit from interventions designed to reduce anxiety and enhance the quality of life.

Keywords

Anxietyasthmaprevalencereviewmeta-analysis
Type
Review Article
Information
Psychological Medicine , Volume 51 , Issue 1 , January 2021 , pp. 11 - 20
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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