The Prevalence of DSM-IV Anxiety and Depressive Disorders in Youth with Asthma Compared with Controls

Abstract

Purpose-To determine the prevalence of anxiety and depressive disorders in youth with asthma compared to a control sample of youth and to determine the sociodemographic and clinical characteristics associated with having ≥1 anxiety/depressive disorders among youth with asthma.Methods-A telephone interview was offered to all youth aged 11 to 17 with asthma (N=781) and a random sample of similar aged controls (N=598) enrolled in a Health Maintenance Organization (HMO). The C-DISC-4.0 was used to diagnose anxiety and depressive disorders and reliable and valid questionnaires were used to assess severity of anxiety and depressive symptoms. Automated diagnostic, pharmacy and health utilization data were used to measure asthma treatment intensity, asthma severity and non-asthmatic medical comorbidity. One parent was interviewed to assess sociodemographic variables, child/adolescent psychiatric symptoms and to confirm the asthma diagnosis.Results-16.3% of youth with asthma compared to 8.6% of youth without asthma met DSM-IV criteria for ≥1 anxiety and depressive disorders (OR = 1.92, 95% CI 1.13-3.28). Independent factors associated with a significantly higher likelihood of meeting criteria for ≥1 anxiety or depressive disorders included female gender [OR = 1.96 (95% CI 1.27, 3.03)], living in a single parent household, [OR = 1.96 (95% CI 1.26, 3.07)], more parent-reported externalizing behaviors [OR = 1.03 (95% CI 1.01, 1.05)], more recent diagnosis of asthma [OR = 0.94 (95% CI 0.89, 0.98)], and more impairment on the asthma physical health scale [OR = 0.95 (95% CI 0.94, 0.96)].Conclusions-Youth with asthma have an almost two-fold higher prevalence of comorbid DSM-IV anxiety and depressive disorders compared to control youth. Clinical factors associated with meeting criteria for ≥1 anxiety and depressive included more recent asthma diagnosis, more impairment on the asthma physical health scale and increased externalizing behaviors. Medicine, 1959 NE Pacific St., Seattle, WA 98195-6560, PH: 206-543-7177, Fax: 206-221-5414, E-Mail: wkaton@u.washington.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Cross-sectional studies have repeatedly found an increased prevalence of panic disorder among youth with asthma. [1][2][3][4][5] A large family history study also recently reported that first degree relatives of patients with panic disorder had a significantly higher prevalence of asthma and chronic obstructive lung disease compared to a control group without panic disorder. NIH Public Access[6] Recent research suggests that youth with asthma also have a high rate of ot...

Anxiety and Depression Screening for Youth in a Primary Care Population

“…However, asthma is the most common chronic disorder in youth, is responsible for high utilization of primary care and is associated with 2-fold higher rates of anxiety and depressive disorders. 17 In addition, our sensitivity analysis allowed estimation of PPV in both groups separately.…”

“…All youth with asthma identified via GHC automated data based on physician ICD-9 asthma diagnoses and asthma medication prescriptions were approached for interview. 17 The control sample of youth was required to have no evidence of asthma medication use or an ICD-9 diagnosis of asthma in the last 12 months. In each 4 to 6 week recruitment wave, each eligible control youth was assigned a unique number and the youth with the lowest 100 numbers were chosen.…”

Asthma-related comorbidities

“…Dyspnea correlates with anxietytrait and anxiety-state, neuroticism and depression in asthmatic men [128]. Katon et al observed that youths with asthma have an almost twofold higher prevalence of comorbid anxiety and depressive disorders compared with controls [129]. In a prospective community-based cohort study of asthmatic patients followed between age 19 and 40 years, asthma was associated with anxiety and panic disorder, while after adjusting for potentially confounding variables, active asthma also predicted subsequent panic disorder [130].…”

Asthma and suicide-related adverse events: a review of observational studies

“…The WHO estimates that there are currently 300 million people suffering from asthma and asthma is also estimated to account for ,250,000 deaths per year worldwide [12,13]. Asthma can have a significant effect on quality of life, and consequences include sleeplessness, daytime fatigue, reduced activity levels, school and work absenteeism, and mental health problems [14][15][16]. It is hypothesised that asthma is a risk factor associated with suicidal behaviour.…”