A link between depression and ED use for asthma?

Previous studies in adults have shown that anxiety and depression can increase emergency department (ED) visits as a result for asthma. A new study in Pediatrics looks at whether the connection exists in pediatric patients.

The researchers used the Massachusetts All-Payer Claims Database for 2014 and 2015 to find patients with asthma who were aged 6 to 21 years and used International Classification of Diseases, 9th and 10th Revision codes to identify diagnoses. The cohort included 63,342 patients with asthma.

In the cohort, they found that 24.7% of the patients had a diagnosis of anxiety, depression, or both (11.2% anxiety only, 5.8% depression only, and 7.7% both). Overall rate of ED use related to asthma was 17.1 ED visits per 100 child-years (95% confidence interval [CI]: 16.7–17.5). After controlling for other chronic illness, insurance type, sex, and age, patients with anxiety had a rate of 18.9 (95% CI: 17.0–20.8) ED visits per 100 child-years and patients with depression had a rate of 21.7 (95% CI: 18.3–25.0). The rate was even higher among patients who had a diagnosis of depression and asthma with 27.6 (95% CI: 24.8–30.3) ED visits. In patients who had did not have a diagnosis for anxiety or depression, the rate of ED visits was 15.5 visits per 100 child-years (95% CI: 14.5–16.4; P < .001).

Researchers concluded that children with asthma who also have anxiety only, depression only, or anxiety and depression are more likely to have higher ED visit rates than children who only have a diagnosis of asthma. In a press release for the study, Naomi Bardach, MD, MAS, said that the study sheds light on a portion of asthma patients who could require more counseling to improve medication compliance as well as symptom recognition.