{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T20:22:40Z","timestamp":1775161360718,"version":"3.50.1"},"reference-count":59,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T00:00:00Z","timestamp":1683244800000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019370","name":"Foundation for Science and Technology","doi-asserted-by":"publisher","award":["PTDC\/MEC-OUT\/29130\/2017"],"award-info":[{"award-number":["PTDC\/MEC-OUT\/29130\/2017"]}],"id":[{"id":"10.13039\/501100019370","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,3,11]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Anxiety and depression are relevant comorbidities in asthma, but, in Portugal and Spain, data on this topic are scarce. We assessed, in patients with asthma, the frequency of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) and the European Quality of Life Five Dimension Questionnaire (EQ-5D); the level of agreement between these questionnaires, and the factors associated with these symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a secondary analysis of the INSPIRERS studies. A total of 614 adolescents and adults with persistent asthma (32.6\u00b116.9 years, 64.7% female) were recruited from 30 primary care centres and 32 allergy, pulmonology and paediatric clinics. Demographic and clinical characteristics, HADS and EQ-5D were collected. A score \u22658 on Hospital Anxiety and Depression Scale-Anxiety\/Hospital Anxiety and Depression Scale-Depression or a positive answer to EQ-5D item 5 indicated the presence of these symptoms. Agreement was determined by Cohen\u2019s kappa. Two multivariable logistic regressions were built.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>According to HADS, 36% of the participants had symptoms of anxiety and 12% of depression. According to EQ-5D, 36% of the participants had anxiety\/depression. The agreement between questionnaires in identifying anxiety\/depression was moderate (k=0.55, 95% CI 0.48 to 0.62). Late asthma diagnosis, comorbidities and female gender were predictors of anxiety\/depression, while better asthma control, health-related quality of life and perception of health were associated with lower odds for anxiety\/depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>At least 1\/3 of the patients with persistent asthma experience symptoms of anxiety\/depression, showing the relevance of screening these disorders in patients with asthma. EQ-5D and HADS questionnaires showed a moderate agreement in the identification of anxiety\/depression symptoms. The identified associated factors need to be further investigated in long-term studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-068725","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T10:22:11Z","timestamp":1683282131000},"page":"e068725","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Symptoms of anxiety and depression in patients with persistent asthma: a cross-sectional analysis of the INSPIRERS studies"],"prefix":"10.1136","volume":"13","author":[{"given":"Mafalda","family":"Sim\u00f5es Cunha","sequence":"first","affiliation":[{"name":"Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0233-830X","authenticated-orcid":false,"given":"Rita","family":"Amaral","sequence":"additional","affiliation":[{"name":"Allergy Unit, Instituto and Hospital CUF, Porto, Portugal"},{"name":"CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal"},{"name":"Department of Cardiovascular and Respiratory Sciences, Porto Health School, Polytechnic Institute of Porto, Porto, Portugal"},{"name":"Department of Women\u2019s and Children\u2019s Health, Paediatric Research, Uppsala University, Uppsala, Sweden"}]},{"given":"Ana Margarida","family":"Pereira","sequence":"additional","affiliation":[{"name":"Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Allergy Unit, Instituto and Hospital CUF, Porto, Portugal"},{"name":"Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal"}]},{"given":"Rute","family":"Almeida","sequence":"additional","affiliation":[{"name":"CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal"}]},{"given":"Magna","family":"Alves-Correia","sequence":"additional","affiliation":[{"name":"Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Allergy Unit, Instituto and Hospital CUF, Porto, Portugal"}]},{"given":"Cl\u00e1udia Chaves","family":"Loureiro","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universit\u00e1rio de Coimbra, Coimbra, Portugal"}]},{"given":"Cristina","family":"Lopes","sequence":"additional","affiliation":[{"name":"Basic and Clinic Immunology, Faculty of Medicine of the University of Porto, Porto, Portugal"},{"name":"Immuno-allergology, Hospital Pedro Hispano, Unidade Local de Sa\u00fade de Matosinhos, Matosinhos, Portugal"}]},{"given":"Joana","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pediatria, Hospital Pedro Hispano, Unidade Local de 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Portugal"}]},{"given":"Cristina","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Unidade de Cuidados de Sa\u00fade Personalizados Norte (Arnaldo Sampaio), Agrupamento de Centros de Sa\u00fade Pinhal Litoral, Monte Redondo, Portugal"}]},{"given":"Maria Jos\u00e9","family":"Calix","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Pediatria, Hospital de S\u00e3o Teot\u00f3nio, Centro Hospitalar Tondela Viseu, Viseu, Portugal"}]},{"given":"Sofia","family":"da Silva","sequence":"additional","affiliation":[{"name":"Unidade de Sa\u00fade Familiar Cuidarte, Unidade Local de Sa\u00fade do Alto Minho, Portuzelo, Portugal"}]},{"given":"Maria Lu\u00eds","family":"Marques","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunoalergologia, Hospital da Senhora da Oliveira, Guimar\u00e3es, Guimaraes, Portugal"}]},{"given":"Ana","family":"Morete","sequence":"additional","affiliation":[{"name":"Allergy Unit, Instituto and Hospital CUF, Porto, 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