Asthma as a predictor of depression, anxiety and their comorbidity in Australian men

Purpose: Examine the long-term association between asthma and mental health conditions in Australian men. Design: Retrospective cohort study. Setting: Ten to Men project from four waves (2014–2022). Subjects: 16,021 Australian men (aged ≥ 18 years) at baseline. Measures: Exposure was self-reported asthma. Outcome measures were depression, anxiety and their comorbidity, assessed through self-reports and validated screening tools. Key covariates included survey year (waves), sociodemographic, lifestyle variables and comorbidities. Analysis: Chi-square test (χ²) of independence for prevalence analysis and generalised estimating equation models for examining associations between asthma and mental health conditions, adjusting for relevant covariates. Results: Across survey years, the prevalence of depression ranged from 12.8% to 33.2%, while anxiety ranged from 17.3% to 51.3%. Comorbid depression with anxiety ranged from 11% to 28%, with the highest prevalence reported in 2020. Asthma was significantly associated with higher risks of depression (RR = 1.23, 95% CI: 1.16, 1.30), anxiety (RR = 1.12, 95% CI: 1.05, 1.18), and comorbid depression with anxiety (RR = 1.27, 95% CI: 1.17, 1.38). Significant risk factors included survey year (2020 and 2022), sleep disturbances and being a former or current smoker. Conclusion: A significant association between asthma and mental health disorders, particularly depression, anxiety, and their comorbidity was identified in Australian men. These highlight the need for an integrated approach to respiratory and mental health care, with particular emphasis on targeted screening and interventions.