Asthma link to mood disorders strengthened

Results from a prospective study support a relationship between asthma in adolescence and future diagnosis of mood disorders.

The Taiwanese data indicated that children aged 10 to 15 years with asthma were over twice as likely to develop bipolar disorder during 10 years of follow-up as children without asthma, and were also significantly more likely to develop major depression or a depressive disorder.

Ya-Mei Bai (Taipei Veterans General Hospital, Taiwan) and colleagues used insurance database information from 1998 to 2000 to identify all children aged 10 to 15 years recognized as having asthma and four randomly selected age- and gender-matched controls for each. Patients were followed-up from the date of asthma diagnosis to the end of 2010.

The incidence of major mood disorders during follow-up was significantly higher among patients with asthma than those without, at 2.8% versus 1.1% for major depression, 6.1% versus 2.6% for any depressive disorder, and 1.0% versus 0.3% for bipolar disorder.

Asthma patients were also significantly more likely to have comorbid allergic disorders, including allergic rhinitis, atopic dermatitis, and allergic conjunctivitis.

In regression analyses, that accounted for the presence of these comorbidities and other confounders, patients with asthma were 1.81-fold more likely to develop major depression, 1.74-fold more likely to develop any depressive disorder, and 2.27-fold more likely to develop bipolar disorder than patients without asthma.

The team also notes that there was no significant relationship between any of the mood disorders and use of inhaled corticosteroids, which have been suggested as a potential mediator of the relationship between asthma and bipolar disorder.

Bai et al explain that while there have been multiple reports of an association between asthma and mood disorders, these have been cross-sectional in nature.

They say that immunologic dysregulation may underlie the association, and there is growing evidence of an important role for proinflammatory cytokines in the development of mood disorders. Additionally, neuroimaging evidence from other studies has shown increased activity during antigen challenge in patients with asthma in the anterior cingulate gyrus and insula, two areas also linked to both major depression and bipolar disorder.

“Determining the underlying pathophysiology of the role of asthma and other allergic diseases in the development of mood disorders needs more investigation,” Bai et al say.

“Further studies also would be required to clarify whether prompt intervention for asthma would decrease the risk of the development of mood disorders,” they add.

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