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Original Research: Asthma |

Mediator Effect of Depressive Symptoms on the Association Between BMI and Asthma Control in AdultsDepressive Symptoms, BMI, and Asthma Control

Maxine Boudreau, BSc; Simon L. Bacon, PhD; Karine Ouellet, BSc; Ariane Jacob, BSc; Kim L. Lavoie, PhD
Author and Funding Information

From the Montreal Behavioural Medicine Centre (Mss Boudreau, Ouellet, and Jacob and Drs Bacon and Lavoie) and Research Centre (Mss Boudreau, Ouellet, and Jacob and Drs Bacon and Lavoie), Hôpital du Sacré-Cœur de Montréal–a University of Montréal affiliated hospital; Department of Psychology (Mss Boudreau, Ouellet, and Jacob and Dr Lavoie), University of Quebec at Montreal; Department of Exercise Science (Dr Bacon), Concordia University; and Research Centre (Drs Bacon and Lavoie), Montreal Heart Institute–a University of Montréal affiliated hospital, Montreal, QC, Canada.

CORRESPONDENCE TO: Kim L. Lavoie, PhD, Montreal Behavioural Medicine Centre, Hôpital du Sacré-Cœur de Montréal–a University of Montréal affiliated hospital, 5400 Gouin W, Montreal, QC, H4J 1C5, Canada; e-mail: k-lavoie@crhsc.rtss.qc.ca


FUNDING/SUPPORT: Direct funding support for this study was provided by the Social Sciences and Humanities Research Counsel of Canada. Additional support was received from the Fonds de la recherche en santé du Québec (FRSQ) (Chercheur-boursier awards to Drs Bacon and Lavoie; scholarships to Mss Boudreau, Ouellet, and Jacob), the Canadian Institutes of Health Research (New Investigator awards to Drs Bacon and Lavoie; scholarship to Ms Boudreau), the FRSQ Respiratory Health Network (scholarship to Ms Boudreau), and the Fonds Québecois de la recherche sur la société et la culture (scholarship to Ms Jacob).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;146(2):348-354. doi:10.1378/chest.13-1796
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BACKGROUND:  Obesity has been associated with worse asthma control. Depression has also been shown to be disproportionally prevalent among patients with asthma and among patients with obesity. However, no studies have examined the mediating effect of depression on the obesity-asthma relationship. This study examined the extent to which depressive symptoms may mediate the obesity-asthma relationship in an adult sample.

METHODS:  A total of 798 patients with physician-diagnosed asthma were recruited from the outpatient asthma clinic at Hôpital du Sacré-Cœur de Montréal. Patients provided demographic and medical history information and completed a battery of questionnaires, including the Beck Depression Inventory (BDI)-II and the Asthma Control Questionnaire (ACQ). BMI was calculated from self-reported height and weight.

RESULTS:  Analyses adjusted for age, sex, years of education, cohabitation, and inhaled corticosteroid dose revealed an association between BMI and ACQ (β = 0.017, P = .026), between BMI and BDI-II (β = 0.189, P = .002), and between BDI-II and ACQ (β = 0.044, P < .001). However, when both BDI-II and BMI were entered into the same model, BDI-II (β = 0.044, P < .001) but not BMI (β = 0.009, P = .226) remained significantly associated with ACQ.

CONCLUSIONS:  The results indicate that depression and a high BMI are both associated with worse asthma control. However, consistent with our hypotheses, the relationship between BMI and worse asthma control was mediated by depressive symptoms. Future studies should examine the precise role of depressive symptoms in both weight and asthma control.

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