Association of Depression in Patients With Chronic Rhinosinusitis Comorbid Asthma and Allergic Rhinitis: A Cross-Sectional Study With the All of Us Research Database

Background Chronic rhinosinusitis (CRS) is a persistent inflammatory condition often coexisting with asthma, allergic rhinitis (AR), and depression, impacting patients’ quality of life. While the relationship between CRS and these comorbidities is recognized, their interaction with depression remains underexplored. Objective This study aimed to investigate the associations of comorbid asthma and AR with depression in CRS patients using the All of Us Database. Methods A cross-sectional analysis was conducted of 27 077 CRS and 244 101 non-CRS patients. Conditions were identified through Systematized Nomenclature of Medicine codes. Generalized linear models were used to calculate adjusted odds ratios (aORs) for associations. Stratified analyses were performed by age, sex, and income. Results CRS patients were more likely to have asthma (32.8% vs 12.2%), AR (52.1% vs 13.1%), and depression (41.7% vs 20.4%). The adjusted GLM revealed significant associations with depression for CRS (aOR = 2.54, 95% confidence interval [CI]: 2.43, 2.65), asthma (aOR = 2.93, 95% CI: 2.84, 3.02), and AR (aOR = 2.67, 95% CI: 2.59, 2.75). Low socioeconomic status (SES) in CRS patients was associated with higher odds of depression (aOR range: [2.70-2.90]). Patients with both CRS and asthma or AR exhibited increased odds of depression (aOR = 1.88 and 1.42). The combination of CRS, asthma, and AR showed the highest risk (aOR = 2.15). Conclusion This study highlights the significant impact of comorbid asthma and AR on depression in CRS patients, with low SES further increasing the likelihood of depression. Our findings underscore the importance of comprehensive management of CRS and its comorbidities, particularly in patients with lower SES.