Psychiatric screening tools in asthma patients: a systematic review

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Introduction: Psychiatric comorbidities, including anxiety, depression, and posttraumatic stress disorder (PTSD), are 1.5 to 2.4 times more prevalent in individuals with asthma than in the general population. Despite their significant impact on disease outcomes, these conditions remain underdiagnosed due to barriers such as time constraints, lack of routine screening protocols, and limited accessibility of validated tools. As a result, screening remains limited. Objective: This systematic review evaluates the efficacy, feasibility, and cost of psychiatric screening tools used in asthma populations. The aim is to identify practical options for clinical implementation and assess potential barriers to their adoption. Methods: A search was conducted across MEDLINE, EMBASE, SCOPUS, CINAHL, and Web of Science for studies published before July 25, 2024. Costs and copyright/accessibility were assessed through internet searches and direct communication. Original validation studies of the tools were reviewed. Results: A total of 23 studies met the inclusion criteria, identifying eight validated psychiatric screening tools for anxiety, depression, and PTSD in asthma populations. These tools were effective in detecting comorbidities, even in undiagnosed patients. Three tools are freely available, while five require a fee. Conclusion: Given a multipartite set of parameters that includes ease of administration, effectiveness, and cost, we recommend a combination of the PHQ-9, GAD-7, and PCL-5 as optimal screening tools for psychiatric comorbidity in primary care and specialty clinics managing adult asthma. Two of these tools are accessible through Alberta’s Epic-based electronic medical record (EMR) system, Connect Care.

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