Background. Asthma and depression are important public-health concerns worldwide. While some epidemiologic studies have shown asthma and wheezing to be associated with depression and anxiety, the patterns are unclear at the multinational level due to the lack of cross-study comparability. Our study examined the associations of self-reported asthma diagnosis and current wheezing with self-reported depression diagnosis and 30-day anxiety using an international survey. Methods. Using the 2002 World Health Survey, a standardized international survey conducted by the WHO, we estimated the associations between diagnosed asthma and current wheezing with diagnosed depression and 30-day anxiety via multiple logistic regressions for 54 countries worldwide. Results. Diagnosed depression and 30-day anxiety were associated with diagnosed asthma in 65% and 40% of the countries, respectively. Diagnosed depression and 30-day anxiety were associated with current wheezing in 83% and 82% of the countries, respectively. Conclusions. The association between asthma and depression was generally seen at the global level. These results indicated the importance of addressing the asthma-depression comorbidity as public-health and clinical management priorities, in order to improve the overall health of the countries. 1. Introduction Asthma was found to be associated with psychological conditions such as stress, anxiety, and depression in observational studies of various sample populations [1–8]. A meta-analysis was conducted by examining 15 publications of primarily cross-sectional, uncontrolled study designs over a total of 1,494 adults [9]. It found that the overall prevalence of anxiety disorders was generally higher among adults with asthma compared to the general population [9]. The age- and sex-adjusted estimates from a study using the World Mental Health Surveys (WMHS) done by 85,052 adults living in 17 countries across the world have demonstrated the links between asthma diagnosis with anxiety disorders, depressive disorders, and alcohol use disorders [10]. Overall, the majority of the epidemiologic studies were limited in geographic coverage, participants’ characteristics (such as age), and information available on factors both related to and unrelated to asthma and depression. In addition, most of these studies used different measurement tools to estimate the occurrences and relationships between asthma and depression. As a result, the comparability of these studies was weakened and the ability to make an overall inference regarding the association between asthma and
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