Depression and Poor Asthma Control Call for Mental Health Attention

Patients with asthma who report depressive symptoms are significantly more likely to describe their disease as poorly controlled and to experience greater symptom burden — yet do not show correspondingly higher rates of exacerbations or reduced spirometric lung function.

Brittany Duchene, MD, assistant professor of medicine at the Larner College of Medicine, University of Vermont, and pulmonary and critical care physician at the University of Vermont Medical Center in Burlington, presented these findings at the 2026 American Thoracic Society (ATS) International Conference in Orlando, Florida.

The cross-sectional analysis used harmonized data from 3 American Lung Association cohorts — ABBS (n = 102), TRIM (n = 38), and TAPE (n = 601) — with depressive symptoms defined by PHQ-9 ≥10 or CES-D ≥16. The primary outcome was urgent asthma-related healthcare utilization in the preceding year. In unadjusted analysis, participants with depressive symptoms had higher odds of utilization (OR, 1.28; 95% CI, 0.92–1.77; P = .146), but this association was not statistically significant and attenuated further after adjustment for BMI, sex, and race (adjusted OR, 1.18; 95% CI, 0.85–1.66; P = .324). BMI emerged as a significant independent predictor (OR per unit increase, 1.03; P = .0036), as did White race, which was protective against utilization compared with non-White participants (OR, 0.59; P = .0010). No effect modification was observed by any subgroup variable.

A companion poster from the same group found that depressive symptoms were associated with approximately twice the odds of poorly controlled asthma despite no significant differences in exacerbation rates or spirometry — a discordance Duchene described as an open and important gap in the literature. The BMI finding carries a practical clinical implication she is direct about communicating to patients: data from Anne Dixon's group demonstrate that even a 5% reduction in body weight improves asthma outcomes, and quantifying that — framing it as roughly 10 pounds — makes the goal tangible.

"Depressive symptoms are an independent factor when it comes to asthma control and symptoms and quality of life — if you have depressive symptoms, you're twice as likely to have poorly controlled asthma, despite correcting the data for BMI, race, and socioeconomic status," Duchene said. "Just getting the message out and having people aware that this is an existing correlation is the first big step."

Duchene reported no relevant disclosures.

Reference

Duchene B, et al. Examining the Role of Depressive Symptoms in Healthcare Utilization for Asthma. Presented at: ATS International Conference; Orlando, Florida; May 2026.