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Open Access Research

Identification of clinically significant psychological distress and psychiatric morbidity by examining quality of life in subjects with occupational asthma

David Miedinger1, Kim L Lavoie123, Jocelyne L'Archeveque1, Heberto Ghezzo1 and Jean-Luc Malo1*

Author Affiliations

1 Division of Chest Medicine, Research Center, Department of Chest Medicine, Hôpital du Sacré-Cœur de Montréal - a University of Montreal affiliated hospital, 5400 Gouin West, Montréal, Québec, H4J 1C5, Canada

2 Department of Psychology, University of Quebec at Montreal (UQAM), P.O. Box 8888, Succursale Center-Ville, Montreal, Quebec, H3C 3P8, Canada

3 Montreal Behavioural Medicine Centre, Research Center, Montreal Heart Institute - a University of Montreal affiliated hospital, 5000 Belanger, Montreal, Quebec, H1T 1C8, Canada

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Health and Quality of Life Outcomes 2011, 9:76  doi:10.1186/1477-7525-9-76

Published: 22 September 2011

Abstract

Background

The Juniper Asthma Specific Quality of Life Questionnaire (AQLQ(S)) is a questionnaire that allows measurement of disease specific quality of life. We wanted to examine correlations between the (AQLQ(S)) general and different subscale scores and both psychiatric morbidity and levels of psychological distress in individuals with occupational asthma (OA) and to determine if results in the emotional function subscale allow identification of individuals with clinically significant psychological distress or current psychiatric disorders.

Methods

This was a cross-sectional study of individuals with OA who were assessed during a re-evaluation for permanent disability, after they were no longer exposed to the sensitizing agent. Patients underwent a general sociodemographic and medical history evaluation, a brief psychiatric interview (Primary Care Evaluation of Mental Disorders, PRIME-MD) and completed a battery of questionnaires including the AQLQ(S), the St-Georges Respiratory Questionnaire (SGRQ), and the Psychiatric Symptom Index (PSI).

Results

There was good internal consistency (Cronbach alpha = 0.936 for the AQLQ(S) total score) and construct validity for the AQLQ(S) (Spearman rho = -0.693 for the SGRQ symptom score and rho = -0.650 for the asthma severity score). There were medium to large correlations between the total score of the AQLQ(S) and the SGRQ symptom score (r = -.693), and PSI total (r = -.619) and subscale scores (including depression, r = -.419; anxiety, r = -.664; anger, r = -.367; cognitive disturbances, r = -.419). A cut-off of 5.1 on the AQLQ(S) emotional function subscale (where 0 = high impairment and 7 = no impairment) had the best discriminative value to distinguish individuals with or without clinically significant psychiatric distress according to the PSI, and a cut-off of 4.7 best distinguished individuals with or without a current psychiatric disorder according to the PRIME-MD.

Conclusions

Impaired quality of life is associated with psychological distress and psychiatric disorders in individuals with OA. Findings suggest that the AQLQ(S) questionnaire may be used to identify patients with potentially clinically significant levels of psychological distress.

Keywords:
Occupational asthma; psychiatric disorder; psychological distress; screening; quality of life