Impact of psychological distress on health status in asthma: Results from the Canadian Community Health Survey

Asthma is among the most common chronic medical conditions and it is associated with decreased health-related quality of life and increased physical co-morbidity, mortality, high rates of clinic visits and hospitalizations, and loss of productivity in the workplace. The objective of the present study was to determine the joint effect of psychological distress and asthma on health status in a community sample. We used data from the Canadian Community and Health Survey (CCHS 3.1) (n=62,274) which was a nationally representative survey conducted in 2005 by Statistics Canada.. Psychological distress was measured by the 10-item Kessler (K10) instrument. Asthma, self-assessed health status, and long-term reduction in activities were assessed by personal interview. Subjects with asthma and high psychological distress reported more often activity limitations and fair/poor health status (70% and 55%, respectively) than those with asthma and moderate psychological distress (45% and 25%, respectively) and those with asthma and low psychological distress (27% and 13%, respectively). Adjusted odds ratio for activity limitations was 2.2 in subjects with asthma alone (poor/fair health status: 2.0), 7.6 for subjects with high psychological distress alone (poor/fair health status: 11.0), and 11.3 for subjects with both, asthma and high psychological distress (poor/fair health status: 16.6). The results suggest that there is a joint effect of psychological distress and asthma on self-perceived health status. Detecting and managing psychological problems might be particularly beneficial for persons with asthma.