Page 61 - Comprehensive treatment of patients with glucocorticoid-dependent severe asthma

Psychological questionnaires
The Hospital Anxiety and Depression Scale (HADS) is a widely used screening questionnaire to identify possible and probable cases [24] of depression (HADS-D) and anxiety (HADS-A) [25], which is reliable in patient and healthy populations [24]. The questionnaire contains 7 anxiety and 7 depression questions, each scoring 0-3 points. A cut off score of ≥11 points was used to define a probable case of anxiety or depression [26].
The NEO-Five-Factor Inventory (NEO-FFI) contains 60 multiple choice questions with a score ranging 1-5 for each answer. The questionnaire measures the 5 leading dimensions of the Big Five-model [27], neuroticism (emotional stability vs. lability), openness (susceptibility to new experiences), extraversion (out- or inwards directed energy and orientation), agreeableness (orientation towards others) and conscientiousness (conscience towards own behavior). In the present study the authorized Dutch translations were used for all questionnaires.
Statistical analysis
Demographic and psychopathological differences between patients with severe, prednisone-dependent asthma, non prednisone-dependent asthma and mild-moderate asthma were analyzed using one-way ANOVA, chi-square tests and Kruskall Wallis tests. The sum scores obtained on the anxiety (HADS-A), depression (HADS-D), neuroticism, openness, extraversion, agreeableness and conscientiousness subscales (NEO-FFI) were analyzed as continuous variables. Potential factors associated with anxiety and depression were analyzed as dichotomous independent variables, using the following contrasts: HADS-D ≥11 vs <11, HADS-A ≥ 11 vs. < 11, asthma duration ≥ 15 yr vs. < 15 yr (median) and BMI ≥ 28 vs. < 28 (median), age >49 vs <49 (median). Odds ratios for anxiety and depression as reference group were obtained by logistic regression analyses.
Asthma duration was defined as the number of years since asthma diagnosis. Number of smoking packyears was calculated by defining 1 packyear of smoking 20 cigarettes /day for a whole year. Chronic use of oral corticosteroids was defined as the daily use of prednisone for at least 1 month before entering the study. Analyses were performed using SPSS version 16.0 (SPSS, Inc., Chicago, IL). P-values lower than 0.05 were considered significant.
Anxiety and depression in asthma
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