Skip to main content Accessibility help

Major depressive disorder is associated with subsequent adult-onset asthma: a population-based cohort study

  • T-C. Shen (a1) (a2), C-L. Lin (a3), C.H. Liao (a4), C-C. Wei (a5), F-C. Sung (a3) (a6) (a7) and C-H. Kao (a1) (a8) (a9)...
  • Please note a correction has been issued for this article.



To examine the incidence of asthma in adult patients with major depressive disorder (MDD).


From the National Health Insurance database of Taiwan, we identified 30 169 adult patients who were newly diagnosed with MDD between 2000 and 2010. Individuals without depression were randomly selected four times and frequency matched for sex, age and year of diagnosis. Both cohorts were followed-up for the occurrence of asthma up to the end of 2011. Adjusted hazard ratios (aHRs) of asthma were estimated using the Cox proportional hazards method.


The overall incidence of asthma was 1.91-fold higher in the MDD cohort than in the non-depression cohort (7.55 v. 3.96 per 1000 person-years), with an aHR of 1.66 (95% confidence interval (CI) 1.55–1.78). In both cohorts, the incidence of asthma was higher in patients and controls who were female, aged, with comorbidities and users of aspirin or beta-adrenergic receptor blockers. No significant difference was observed in the occurrence of asthma between patients with MDD treated with selective serotonin reuptake inhibitors (SSRIs) and those treated with non-SSRIs (SSRIs to non-SSRIs aHR = 1.03, 95% CI 0.91–1.17).


Adult patients with MDD are at a higher risk of asthma than those without depression are.


Corresponding author

*Address for correspondence: C-H. Kao, MD, Professor, Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yude Road, Taichung 404, Taiwan. (Email:


Hide All

These authors contributed equally to this work.

There was an error of omission in the title that has now been corrected and a notice has been published providing details.



Hide All
American Psychiatric Association (2013). The Diagnostic and Statistical Manual of Mental Disorders, 5th edn (DSM-5). American Psychiatric Association: Arlington, VA.
Boulet, LP (2009). Influence of comorbid conditions on asthma. European Respiratory Journal 33, 897906.
Brown, ES, Vigil, L, Khan, DA, Liggin, JD, Carmody, TJ, Rush, AJ (2005). A randomized trial of citalopram versus placebo in outpatients with asthma and major depressive disorder: a proof of concept study. Biological Psychiatry 58, 865870.
Brown, ES, Howard, C, Khan, DA, Carmody, TJ (2012). Escitalopram for severe asthma and major depressive disorder: a randomized, double-blind, placebo-controlled proof-of-concept study. Psychosomatics 53, 7580.
Brunner, WM, Schreiner, PJ, Sood, A, Jacobs, DR Jr. (2014). Depression and risk of incident asthma in adults. The CARDIA study. American Journal of Respiratory and Critical Care Medicine 189, 10441051.
Covar, RA, Macomber, BA, Szefler, SJ (2005). Medications as asthma triggers. Immunology and Allergy Clinics of North America 25, 169190.
de Nijs, SB, Venekamp, LN, Bel, EH (2013). Adult-onset asthma: is it really different? European Respiratory Review 22, 4452.
Fu, TS, Lee, CS, Gunnell, D, Lee, WC, Cheng, AT (2013). Changing trends in the prevalence of common mental disorders in Taiwan: a 20-year repeated cross-sectional survey. Lancet 381, 235241.
GINA Report. Global Strategy for Asthma Management and Prevention. Retrieved 11 August 2015 from
Goodwin, RD, Jacobi, F, Thefeld, W (2003). Mental disorders and asthma in the community. Archives of General Psychiatry 60, 11251130.
Henriksen, L, Simonsen, J, Haerskjold, A, Linder, M, Kieler, H, Thomsen, SF, Stensballe, LG (2015). Incidence rates of atopic dermatitis, asthma, and allergic rhinoconjunctivitis in Danish and Swedish children. Journal of Allergy and Clinical Immunology 136, 360366.
Jiang, M, Qin, P, Yang, X (2014). Comorbidity between depression and asthma via immune-inflammatory pathways: a meta-analysis. Journal of Affective Disorders 166, 2229.
Kitch, BT, Levy, BD, Fanta, CH (2000). Late onset asthma: epidemiology, diagnosis and treatment. Drugs and Aging 17, 385397.
Leander, M, Lampa, E, Rask-Andersen, A, Franklin, K, Gislason, T, Oudin, A, Svanes, C, Torén, K, Janson, C (2014). Impact of anxiety and depression on respiratory symptoms. Respiratory Medicine 108, 15941600.
Lee, CW, Liao, CH, Lin, CL, Liang, JA, Sung, FC, Kao, CH (2015). Increased risk of osteoporosis in patients with depression: a population-based retrospective cohort study. Mayo Clinic Proceedings 90, 6370.
Lehrer, P, Feldman, J, Giardino, N, Song, HS, Schmaling, K (2002). Psychological aspects of asthma. Journal of Consulting and Clinical Psychology 70, 691711.
Lin, YN, Lin, CL, Chang, YJ, Peng, CL, Sung, FC, Chang, KC, Kao, CH (2014). Increased subsequent risk of acute coronary syndrome for patients with depressive disorder: a nationwide population-based retrospective cohort study. Psychiatry and Clinical Neurosciences 68, 263269.
Loerbroks, A, Apfelbacher, CJ, Bosch, JA, Stürmer, T (2010). Depressive symptoms, social support, and risk of adult asthma in a population-based cohort study. Psychosomatic Medicine 72, 309315.
Mannino, DM (2008). Doc, my asthma (depression) has gotten me down (wheezing). Chest 134, 11161117.
Mohanan, S, Tapp, H, McWilliams, A, Dulin, M (2014). Obesity and asthma: pathophysiology and implications for diagnosis and management in primary care. Experimental Biology and Medicine/Society for Experimental Biology and Medicine 239, 15311540.
Patten, SB, Williams, JV, Lavorato, DH, Modgill, G, Jetté, N, Eliasziw, M (2008). Major depression as a risk factor for chronic disease incidence: longitudinal analyses in a general population cohort. General Hospital Psychiatry 30, 407413.
Postma, DS, Rabe, KF (2015). The asthma-COPD overlap syndrome. New England Journal of Medicine 373, 12411249.
Reddy, MS (2010). Depression: the disorder and the burden. Indian Journal of Psychological Medicine 32, 12.
Ritz, T, Claussen, C, Dahme, B (2001). Experimentally induced emotions, facial muscle activity, and respiratory resistance in asthmatic and non-asthmatic individuals. British Journal of Medical Psychology 74, 167182.
Sanfiorenzo, C, Pipet, A (2011). Exacerbations of asthma–precipitating factors: drugs. Revue des Maladies Respiratoires 28, 10591070.
Shen, TC, Tu, CY, Lin, CL, Wei, CC, Li, YF (2014). Increased risk of asthma in patients with systemic lupus erythematosus. American Journal of Respiratory and Critical Care Medicine 189, 496499.
Shen, TC, Lin, CL, Wei, CC, Chen, CH, Tu, CY, Hsia, TC, Shih, CM, Hsu, WH, Sung, FC (2015 a). The risk of asthma in patients with ankylosing spondylitis: a population-based cohort study. PLoS ONE 10, e0116608.
Shen, TC, Lin, CL, Wei, CC, Chen, CH, Tu, CY, Hsia, TC, Shih, CM, Hsu, WH, Sung, FC, Kao, CH (2015 b). Risk of obstructive sleep apnea in adult patients with asthma: a population-based cohort study in Taiwan. PLoS ONE 10, e0128461.


Related content

Powered by UNSILO

Major depressive disorder is associated with subsequent adult-onset asthma: a population-based cohort study

  • T-C. Shen (a1) (a2), C-L. Lin (a3), C.H. Liao (a4), C-C. Wei (a5), F-C. Sung (a3) (a6) (a7) and C-H. Kao (a1) (a8) (a9)...
  • Please note a correction has been issued for this article.


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.

A correction has been issued for this article: