Association of asthma control, treatment, adherence, lung function, and allergy sensitization with depressive symptoms and quality of life in a real-life setting

Introduction Asthma is a chronic inflammatory respiratory disease that is frequently associated with emotional distress and impaired quality of life. However, how clinical factors, such as treatment, adherence, lung function, and allergy sensitization, relate to depressive symptoms remains unclear. In this study, we examined the associations among asthma control, treatment, adherence, lung function, allergy sensitization, somatic and cognitive-affective depressive symptoms, and quality of life in a real-life clinical setting. Methods This cross-sectional study included adults with asthma attending tertiary pneumology and allergy services, and their asthma symptoms were evaluated using the standardized measures of the Asthma Control Test, GINA 2022 (treatment), Test of Adherence to Inhalers, lung function, skin prick test for allergy sensitization, PHQ-9 (depressive symptoms), Asthma Quality of Life Questionnaire, serum eosinophils and IgE levels. Results Of 102 asthma patients, 51% of participants scored more than 5 points on the PHQ-9, indicating the presence of depression. Poor asthma control and lower adherence scores were significantly associated with higher depressive symptoms ( r s = −0.36, p < 0.001; r s = 0.41, p < 0.001) and poorer quality of life ( r s = 0.50, p < 0.001), whereas objective lung function like reduced forced vital capacity ( r s = 27, p = 0.05) was weakly associated with depressive symptoms. Eosinophils count ( r s = 0.02), IgE ( r s = 0.06) or allergy sensitization ( r s = 0.08) markers showed nonsignificant associations with emotional outcomes. Conclusion Emotional distress and quality of life are more strongly related to patients’ perceived control of their disease and adherence behaviors than to objective physiological markers. Thus, psychological and self-management strategies should be integrated into routine asthma care.