Depression in patients under investigation for occupational asthma: clinical, immune, behavioral, and employment aspects
Bibliographic record
Abstract
Asthma and depression are highly prevalent and often co-occurring conditions with substantial personal, social, and economic impact worldwide. Little is known about psychological factors in occupational asthma (OA), a type of asthma caused by exposure to workplace substances. Individuals under medical investigation for OA face distressing respiratory symptoms and uncertain occupational implications. Although preliminary evidence indicates a high rate of depression among patients under investigation for OA (UIOA), the impact of depression on patient health and well-being is unclear. The current dissertation examines whether major depressive disorder (MDD) and depressive symptomatology contribute to the burden of illness in people UIOA. Two original research studies were conducted, considering multiple clinical and functional aspects: respiratory symptom burden, physiological indices including lung function and immune alterations, health behaviors, and employment. Study 1 examined the cross-sectional relationships between depression and respiratory symptom burden in a sample of 220 patients currently being evaluated for OA. Participants underwent a socio-demographic, medical, and psychiatric interview, and completed a battery of questionnaires on the day of their asthma clinic visit. Hospital medical chart reviews were conducted to obtain physiological, diagnostic, and prescription information. Results showed that MDD and higher depressive symptoms were associated with worse control of respiratory symptoms, worse quality of life related to respiratory symptoms, and an increased percentage of eosinophils in sputum. Depressive symptoms were also associated with an increased percentage of neutrophils and a decreased percentage of lymphocytes in blood. MDD was associated with smoking.Extending this work, Study 2 examined longitudinal associations between baseline MDD and depressive symptoms with future respiratory and occupational outcomes in 131 patients who were re-contacted approximately 18 months after their initial evaluation for OA in Study 1. Participants again underwent a socio-demographic, medical, and psychiatric interview, and completed a battery of questionnaires. Results indicated that patients with MDD and those who report more depressive symptoms during evaluation for OA tend to have more poorly controlled respiratory symptoms at follow-up relative to other patients. Over time, measures of baseline depression were also associated with deteriorating quality of life related to respiratory symptoms, failure to return to work, and increasing on-the-job limitations. Overall, findings suggest that MDD and depressive symptoms play a significant role in the health and well-being of people UIOA. The present research adds to the growing chronic illness literature demonstrating the adverse effects of depression on health and employment. Implications and directions for future research are discussed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".