Assessment of Depression and Internalized Stigma among Adult Asthma Patients

Abstract Objective: Suboptimal asthma control among significant number patients are linked with various psycho-social factors, such as depression and stigma. These factors play an obstructive role for better asthma management. The aim of this study is to assess depressive symptoms and internalized stigma collectively among adult asthma patients, and investigate how these two factors are related with other sociodemographic and asthma related medical factors. Methods: In this cross-sectional study, 325 adult asthma patients (aged > 18 years old) were recruited from National Asthma Centre, Dhaka, Bangladesh. Researcher-administered questionnaire was used to enroll participants by convenience sampling method. The questionnaire consisted of four sections: socio-demographic characteristics, medical data, 9-item patient health (PHQ-9) to assess depressive symptoms, and 22 items stigma scale to assess internalized stigma. The extracted data were analyzed using descriptive and inferential statistics using the Statistical Package for Social Sciences (SPSS®), version 22. Results: Most of the participants in this study (n=325), were between 18 to 40 years old n(%) 176(54.2), male 174(53.5), from rural areas 165(50.8), had monthly family income (<US$250) 179(55.1), years of asthma diagnosed > 5years 151(46.5). The mean±SD PHQ-9 score was 7.36(±6), reflected mild depressive symptoms, while internalized stigma score was 62.2(±10.26), moderate internalized stigma. Depression was significantly different across age, education, ED visit, hospitalized for asthma, number of asthma medicine, home nebulizer use, PEF rate, BMI, comorbidity, and asthma symptom control (p<0.05). Stigma was significantly different across age, education, occupation, years of asthma diagnosed, home nebulizer, type of inhaler, PEF rate, BMI, comorbidity and asthma symptom control (p<0.05). Stigma was significantly correlated with depression and negatively correlated with age and years of asthma diagnosed (p<0.01). Conclusion: This study showed various factors are associated with depressive symptoms and internalized stigma among enrolled asthma patients. Stigma was higher among younger adults and recent asthma diagnosed. Intervention is needed to reduce stigma and depression.