Misdiagnosis of Asthma in Patients with Anxiety/Depression

Authors : Barış Çil, Mehmet Kabak

Pages : 183-188

Doi:10.38175/phnx.1304577

View : 97 | Download : 151

Publication Date : 2023-11-01

Article Type : Research Paper

Abstract :Objective: Anxiety/depression may lead to misdiagnosis of asthma if respiratory symptoms are prominent. In this study, we aimed to evaluate misdiagnosis due to anxiety and depression among patients diagnosed with asthma. Material and Methods: This prospective study included patients who were previously diagnosed with asthma and evaluated by a psychiatrist through the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). The patients were divided into two groups in terms of their BDI/BAI status as positive (mild, moderate or severe category) or negative (normal category). The groups were compared in terms of clinical characteristics, pulmonary function tests, asthma control tests (ACT), and atopy parameters. Results: We identified 54 patients (32.7%) in BDI/BAI(+) group. Compared to that in BDI/BAI(+) group, patients in the BDI/BAI(-) group were more likely to have family history of asthma (37.0% vs. 65.7%, p<0.001). The mean ACT score in the BDI/BAI(+) group was significantly lower than that in the BDI/BAI(-) group (15.9 vs. 19.3, respectively, p<0.001). Significantly less patients in BDI/BAI(+) group had evidence of obstruction (14.8%) and reversibility (14.8%) compared to those in BDI/BAI(-) group (57.7% and 54.1%, respectively; p<0.001 for each). While total IgE and ACT were the tools with highest sensitivity (72% and 70%, respectively), skin prick test had the highest specificity (92%). Obstruction (88%) and reversibility (88%) had the highest positive predictive values. Conclusion: The presence of dyspnea on the basis of asthma diagnosis may lead to misdiagnosis in some patients, especially in individuals with anxiety/depression. The history of patients presenting dyspnea symptoms should be taken carefully and examined in detail by spirometric and laboratory workup.
Keywords : Yanlış astım tanısı, Anksiyete, Depresyon, Nefes darlığı, Solunum fonksiyon testi