Relationship between quality of life and behavioural disorders in children with persistent asthma: a Multiple Indicators Multiple Causes (MIMIC) model

Abstract

37 , franca Rusconi 11,37 & the italian pediatric Severe Asthma network (ipSAn) program of italian paediatric Respiratory Society (ipRS) † Knowledge on multiple interdependences between quality of life (QoL) and behavioural problems in relation to asthma severity and control is undetermined. the aims of the study were: (i) to assess the relationship of QoL and behavioural problems with asthma severity and control (ii) to predict children's "abnormal/borderline" status with variation in QoL. for these purposes a multicenter case-control study on 47 Severe Asthma (SA) and 94 Moderate Asthma (MA) children was performed. The MIMIC approach was applied to investigate the effect of SA and non-controlled asthma (NC) on QoL and behavioural disorders. Logistic regression was used to estimate probabilities of having an "abnormal/ borderline" status with variation in QoL. The MIMIC model showed that the magnitude of the effect of SA and nc was larger on QoL (β = −0.37 and β = −0.30, respectively) than on behavioural problems (β = 0.27). With regards to the probability of having a borderline status, in MA a QoL of 1 returned a probability of 0.81, whereas in SA a QoL of 1 returned a probability of 0.89. In conclusion, SA children are highly affected by impaired QoL and behavioural problems. The MIMIC model allowed us to obtain a comprehensive assessment of QoL and behavioural problems with asthma severity and control.Asthma is one of the most common chronic illnesses of childhood. In clinical practice, physicians are generally focused on diagnosis and treating the respiratory aspects of the disease; however, there are other factors, including psychological facets, which contribute to the disease course, including quality of life (QoL). Children with

Asthma control and psychological health in pediatric severe asthma

“…On the whole, the findings have been consistent that children with asthma have a higher prevalence of anxiety and depression compared with nonasthmatic control groups, 25–28 and anxiety and depression may be more prevalent the greater the asthma severity rating. A recent study by Montalbano et al 9 demonstrated that quality of life impairment and internalizing behavioral problems, especially the subscale including symptoms of anxiety and depressive symptoms, are more common in children with severe asthma than nonsevere asthma. Notably, there were no sex differences identified in that cohort.…”

“…4,5 The presence of psychiatric comorbidity in general pediatric asthma cohorts has been shown to increase symptom severity, reduce asthma control, lower quality of life, and lower medication adherence, 6 possibly mediated by heightened perception of respiratory symptoms 7 ; however, there are few data assessing anxiety and depression in children with severe asthma. 8,9 While evaluation of mental health comorbidities is highly recommended in the assessment of children with severe asthma, 10,11 there is little data specific to mental health comorbidities in the pediatric severe asthma population. Therefore, we aimed to determine the prevalence and character of mental health issues in pediatric severe asthma and its relationship to asthma control.…”

Co‐morbid anxiety and depression in childhood asthma and its effect on symptom control: A cross sectional study

“…It was also seen that anxiety and depression affected the control of asthma and caused frequent exacerbations of asthma in these children. In a more recent study evaluating the relationship between quality of life and behavioral disorders in children with persistent asthma, it was found that children with severe asthma were more often affected with impaired quality of life and behavioral problems 6 . Awareness of the association between anxiety and depression in children with asthma is poor especially in resource limited settings.…”

“…In a more recent study evaluating the relationship between quality of life and behavioral disorders in children with persistent asthma, it was found that children with severe asthma were more often affected with impaired quality of life and behavioral problems. 6 Awareness of the association between anxiety and depression in children with asthma is poor especially in resource limited settings. This study was undertaken to identify the burden of comorbid anxiety and depression in asthmatic children belonging to our region and to find out how it affects symptom control in these children.…”

The Therapeutic Effect of Extracellular Vesicles on Asthma in Pre-clinical Models: A Systematic Review Protocol

“…Severe asthma, to a greater extent than moderate asthma, is associated with a lower quality of life and behavioural problems in children 18 . If left untreated, asthma can lead to severe respiratory distress or even death.…”