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Gupta S, Thériault G. Do not diagnose or routinely treat asthma or chronic obstructive pulmonary disease without pulmonary function testing. BMJ 2023; 380:e072834. [PMID: 36940980 DOI: 10.1136/bmj-2022-072834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- Samir Gupta
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health, Toronto, Canada
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, Canada
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Asrullah M, L’Hoir M, Paulo MJ, Feskens EJM, Melse-Boonstra A. Determinants of Common Mental Disorders (CMD) among adolescent girls aged 15-19 years in Indonesia: Analysis of the 2018 National Basic Health Survey Data. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000232. [PMID: 36962366 PMCID: PMC10021533 DOI: 10.1371/journal.pgph.0000232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/01/2022] [Indexed: 11/18/2022]
Abstract
Common Mental Disorders (CMD) are distress conditions which manifest themselves with anxiety, somatic, and depressive symptoms. CMD are highly prevalent in Indonesia especially among adolescents. Adolescent girls have a higher risk to develop CMD than boys. This may be related to anaemia, potentially aggravated by early onset of menstruation. This study aimed to determine the association between haemoglobin concentration and other determinants of CMD among adolescent girls in Indonesia. Data of 1,052 adolescent girls aged 15-19 years old from the Indonesian Basic Health Survey 2018 were analysed. CMD was measured using the Self Reporting Questionnaire (SRQ-20). Principal Component Analysis of main determinants was applied and resulting principal components were investigated as risk factors for CMD. The prevalence of CMD among the study population was 16.5%. Anaemia and Age at Menarche (AAM) were not associated with CMD. Three principal components were significantly associated with higher CMD score: 1) higher parental education, better employment of the father, and living in an urban area (β: 0.16, 95%-CI: 0.02; 0.30); 2) higher consumption of salty foods, high-fat foods, and soft drinks (β: 0.23, 95%-CI: 0.05; 0.40); and 3) having asthma, smoking, and a higher haemoglobin concentration (β: 1.74, 95%-CI: 1.59; 1.89). The strongest clustered associates of CMD among adolescent girls in Indonesia were asthma, smoking status, and higher haemoglobin concentration, whereas anaemia and AAM were not associated. Causality of smoking and diet to CMD could not be disentangled in this cross-sectional study. Our findings imply that adolescent girls who have asthma and smoke, as well as those having parents with higher education and secured occupation, are more likely to have mental disorders.
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Affiliation(s)
- Muhammad Asrullah
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Monique L’Hoir
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Maria-João Paulo
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
- Biometris, Wageningen University and Research, Wageningen, The Netherlands
| | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Alida Melse-Boonstra
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
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Abstract
PURPOSE OF REVIEW Severe asthma is often associated with numerous comorbidities that complicate disease management and affect patient's outcomes. They contribute to poor disease control and mimic asthma symptoms. Although some comorbidities such as obstructive sleep apnea, bronchiectasis, and chronic obstructive pulmonary disease are generally well recognized, many other may remain undiagnosed but may be detected in an expert specialist setting. The management of comorbidities seems to improve asthma outcomes, and optimizes therapy by avoiding overtreatment. The present review provides recent knowledge regarding the most common comorbidities which are associated with severe asthma. RECENT FINDINGS Comorbidities are more prevalent in severe asthma than in mild-to-moderate disease or in the general population. They can be grouped into two large domains: the pulmonary domain and the extrapulmonary domain. Pulmonary comorbidities include upper respiratory tract disorders (obstructive sleep apnea, allergic and nonallergic rhinitis, chronic rhinosinusitis, nasal polyposis) and middle/lower respiratory tract disorders (chronic obstructive pulmonary disease, allergic bronchopulmonary aspergillosis and fungal sensitization, bronchiectasis, dysfunctional breathing). Extrapulmonary comorbidities include anxiety, depression, gastro-esophageal reflux disease, obesity, cardiovascular, and metabolic diseases. SUMMARY The identification of comorbidities via multidimensional approach is needed to initiate appropriate multidisciplinary management of patients with severe asthma.
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Vazquez‐Ortiz M, Angier E, Blumchen K, Comberiati P, Duca B, DunnGalvin A, Gore C, Hox V, Jensen B, Pite H, Santos AF, Sanchez S, Alviani C, Garriga‐Baraut T, Knibb R, Mortz CG, Gowland MH, Timmermans F, Roberts G. Understanding the challenges faced by adolescents and young adults with allergic conditions: A systematic review. Allergy 2020; 75:1850-1880. [PMID: 32141620 DOI: 10.1111/all.14258] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/26/2020] [Accepted: 02/20/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adolescence represents a vulnerable time for individuals with asthma and allergic conditions. They suffer an unexpected degree of morbidity. This systematic review aimed to understand the challenges faced by adolescents and young adults with these conditions. METHODS A systematic literature search was undertaken across eight databases. References were checked by two reviewers for inclusion. Study data were extracted, and their quality was assessed in duplicate. A narrative meta-synthesis was undertaken. RESULTS A total of 108 papers describing 106 studies were retrieved, most focused on asthma. Five themes were identified across studies: (a) Health-related quality of life-impairment was associated with poor disease control, psychosocial issues, adolescent-onset allergic disease and female sex; (b) Psychological factors-asthma and food allergy were associated with anxiety and depression, atopic dermatitis was associated with suicidal ideation, and that parental emotional support may be protective; (c) Adherence-suboptimal adherence was associated with older age, barriers to medication usage, poor symptom perception and failure to take responsibility, and positive factors were routines, simpler treatment regimes, better knowledge and perceptions about medications; (d) Self-management-facilitated by education, knowledge and a positive attitude; and (e) Supportive relationships-families could modify barriers to adherence and foster positive views about self-management, adolescents suggested that their peers should be more involved in supporting them, and adolescents also wished to have support from nonjudgemental healthcare professionals. CONCLUSIONS We have some understanding of the challenges faced by adolescents with asthma, less so for other allergic conditions. This knowledge will be used to support guidelines for managing adolescents.
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Affiliation(s)
- Marta Vazquez‐Ortiz
- Department of Paediatrics Faculty of Medicine Imperial College London London UK
| | - Elizabeth Angier
- Primary Care and Population Sciences University of Southampton Southampton UK
| | - Katharina Blumchen
- Department of Paediatric and Adolescent Medicine Paediatric Pneumology Allergology and Cystic Fibrosis University Hospital Frankfurt Frankfurt am Main Germany
| | - Pasquale Comberiati
- Section of Paediatrics Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
- Department of Clinical Immunology and Allergology I.M. Sechenov First Moscow State Medical University Moscow Russia
| | - Bettina Duca
- Department of Paediatrics Imperial College London London UK
| | - Audrey DunnGalvin
- Applied Psychology and Paediatrics and Child Health University College Cork Cork Ireland
- Paediatrics and Child Infectious Diseases First Moscow State Medical University Moscow Russia
| | - Claudia Gore
- Department of Paediatrics Imperial College London London UK
- Department of Paediatrics Imperial College Healthcare NHS Trust London UK
| | - Valérie Hox
- Department of Otorhinolaryngology Head and Neck Surgery University Hospitals Saint‐Luc Brussels Belgium
| | - Britt Jensen
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital University of Southern Denmark Odense Denmark
| | - Helena Pite
- Allergy Center CUF Descobertas Hospital and CUF Infante Santo Hospital Lisbon Portugal
- CEDOC Chronic Diseases Research Center NOVA Medical School/Faculdade de Ciências Médicas Universidade Nova de Lisboa Lisbon Portugal
| | - Alexandra F. Santos
- Department of Women and Children’s Health (Paediatric Allergy) Faculty of Life Sciences and Medicine School of Life Course Sciences King’s College London London UK
- Peter Gorer Department of Immunobiology School of Immunology and Microbial Sciences King’s College London London UK
- Children’s Allergy Service Guy’s and St Thomas’ Hospital London UK
- Asthma UK Centre in Allergic Mechanisms of Asthma London UK
| | - Silvia Sanchez
- Allergy Department Hospital Infantil Universitario del Niño Jesús Madrid Spain
| | - Cherry Alviani
- University of Southampton Faculty of Medicine Southampton UK
- The David Hide Asthma and Allergy Research Centre St Mary’s Hospital Isle of Wight UK
| | - Teresa Garriga‐Baraut
- Unitat d'Al.lergologia Pediàtrica Hospital Universitari Vall d'Hebron Barcelona Spain
- Grup d’Investigació “Creixement i Desenvolupament” Institut de Recerca de l’Hospital Universitari Vall d’Hebron (VHIR) Barcelona Spain
| | - Rebecca Knibb
- Department of Psychology School of Life and Health Sciences Aston University Birmingham UK
| | - Charlotte G. Mortz
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital University of Southern Denmark Odense Denmark
| | | | - Frans Timmermans
- Frans Timmermans: Nederlands Anafylaxis Netwerk – European Anaphylaxis Taskforce Dordrecht The Netherlands
| | - Graham Roberts
- University of Southampton Faculty of Medicine Southampton UK
- The David Hide Asthma and Allergy Research Centre St Mary’s Hospital Isle of Wight UK
- NIHR Southampton Biomedical Research Centre University Hospital Southampton NHS Foundation Trust Southampton UK
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Cobham VE, Hickling A, Kimball H, Thomas HJ, Scott JG, Middeldorp CM. Systematic Review: Anxiety in Children and Adolescents With Chronic Medical Conditions. J Am Acad Child Adolesc Psychiatry 2020; 59:595-618. [PMID: 31676391 DOI: 10.1016/j.jaac.2019.10.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/22/2019] [Accepted: 10/17/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Youth with chronic medical conditions (CMCs) have been reported to be at increased risk for developing anxiety disorders. Importantly, suffering from anxiety may also have an impact on their disease-related outcomes. This study set out to systematically review the literature on anxiety and seven CMCs (asthma, congenital heart disease, diabetes, epilepsy, inflammatory bowel disease, juvenile idiopathic arthritis, and sickle cell disease) among youth. METHOD A systematic review was performed according to the PRISMA statement. Searches were conducted across PubMed, PsycNET, Embase, and reference lists of the included studies (1990-2018). Three independent reviewers screened titles and abstracts and conducted full-text assessment. Studies were included if they reported the prevalence of anxiety or the association of anxiety on disease-related outcomes in children and/or adolescents with the focal CMCs. RESULTS A total of 53 studies met the predetermined inclusion criteria. Across the CMCs, the prevalence of anxiety disorder was increased in youths with CMCs compared to the general population. Evidence for a relationship between anxiety and adverse disease-related outcomes was limited. For asthma, inflammatory bowel disease, and sickle cell disease, there was some evidence indicating that anxiety was associated with adverse outcomes; supported by two longitudinal studies, one in asthma and one in inflammatory bowel disease. For diabetes, results were inconsistent; with some studies indicating that anxiety was associated with worse and others with better treatment adherence. CONCLUSION The prevalence of anxiety disorders in youth with CMCs is higher than that in the general population. Anxiety may also be associated with adverse disease-related outcomes for youths, but it is not possible to draw definitive conclusions. Longitudinal studies making use of parent/youth composite anxiety measures and a combination of parent/youth reported and objective measures of disease-related outcomes are needed. Given the burden of disease of anxiety disorders, regardless of the impact on the disease outcomes, screening for and treatment of anxiety is recommended in youths with CMCs.
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Affiliation(s)
- Vanessa E Cobham
- Child and Youth Mental Health Service [CYMHS], Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia; School of Psychology, The University of Queensland, Brisbane, Australia.
| | - Anna Hickling
- School of Psychology, The University of Queensland, Brisbane, Australia; Mater Research Institute, Brisbane, Queensland, Australia
| | - Hayley Kimball
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Hannah J Thomas
- Queensland Centre for Mental Health Research, Brisbane, Australia, and the Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia; School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - James G Scott
- Queensland Centre for Mental Health Research, Brisbane, Australia, and the Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Metro North Mental Health Service, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia, and QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Christel M Middeldorp
- Child and Youth Mental Health Service [CYMHS], Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia; Child Health Research Centre, The University of Queensland, Brisbane, Australia, and Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Kyung Y, Choi MH, Jeon YJ, Lee JS, Lee JH, Jo SH, Kim SH. Association of atopic dermatitis with suicide risk among 788,411 adolescents: A Korean cross-sectional study. Ann Allergy Asthma Immunol 2020; 125:55-64. [PMID: 32240758 DOI: 10.1016/j.anai.2020.03.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 03/16/2020] [Accepted: 03/18/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is known to negatively influence the mental health of patients. However, only a few studies have explored the influencing factors for psychiatric problems among adolescents with AD. OBJECTIVE To assess the association of AD and suicidal behaviors among adolescents by analyzing data from the 3rd through the 13th annual Korean Youth Risk Behavior Web-based Surveys (completed from 2007 to 2017). METHODS Survey data were obtained from a stratified, multistage, clustered sample. Students self-reported AD if they had received a diagnosis of AD by a physician. Influencing factors for suicidal behaviors were tested by logistic regression models. RESULTS A total of 788,411 adolescents completed the survey. The proportion of participants with AD was 22.2%. Those reporting suicide ideation and suicide attempts were 19.0%, and 4.5%, respectively. Compared with adolescents without AD, those with AD were more likely to be female, to skip breakfast less frequently, to exercise less frequently, to drink less alcohol, and to not be current smokers and were statistically significantly more likely to have negative mental health states. In the multivariable model, perceived unhappiness and suicidal ideation were the strongest influencing factors for suicidal ideation (adjusted odds ratio, 4.90; 95% CI, 4.31-5.57) and for suicidal attempts (adjusted odds ratio, 48.01; 95% CI, 42.69-53.09), respectively. CONCLUSION Adolescents with AD had a meaningful prevalence of suicidal behaviors. Although further research is needed to clarify this association, adolescents with AD with influencing factors for negative mental health state may need intervention from practitioners who use a multidisciplinary team approach to prevent suicide.
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Affiliation(s)
- Yechan Kyung
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Min Hwan Choi
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Yoo Jung Jeon
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Jun Hwa Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Seon Hui Jo
- Department of Biostatistics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Sung Hoon Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
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Plourde V, Kung JY, Gates A, Jun S, Brooks BL, Sebastianski M. How Perceptions Impact Recovery from Concussion in Childhood and Adolescence: a Systematic Review. Neuropsychol Rev 2020; 30:142-163. [PMID: 32124152 DOI: 10.1007/s11065-020-09430-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 02/16/2020] [Indexed: 12/24/2022]
Abstract
Perceptions about the causes and consequences of concussion, and individual representations and interpretations of these factors, can influence the post-concussive recovery process. The goal of this project was to synthesize evidence on perceptions related to concussions as experienced by children, adolescents, and parents, and to evaluate how these perceptions impact post-concussive recovery in physical, behavioural, cognitive, and psychological domains. We undertook a systematic review based on the Cochrane Handbook, conducting a comprehensive search of six databases and Google Scholar. Duplicate, independent screening was employed and the quality of studies was assessed using the Mixed Methods Appraisal Tool (MMAT). A total of 1552 unique records were identified, and six records (5 scientific articles and 1 thesis, published between 1990 and 2018; N = 26 to 412, age range from 2 to 18 years) were included. Perceptions about concussions were assessed differently between studies, with a range in types of measures and respondents. Some evidence suggested that perceptions could negatively impact concussion recovery, mostly post-concussive symptoms. However, results were not consistent between studies and the methodological quality was variable (and often low). There is limited evidence of the impact of perceptions of children, adolescents, and their parents on concussion recovery. Priorities for future research investigating concussion recovery should include recruiting representative samples, accounting for potential confounders, and measuring perceptions in children, adolescents and parents using validated measures. Higher quality studies are needed to better understand the role of perceptions in concussion recovery and to inform clinical care.
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Affiliation(s)
- Vickie Plourde
- School of Psychology, Université de Moncton, 18 Av Antonine-Maillet, Moncton, NB, E1A 3E6, Canada.
| | - Janice Y Kung
- John W. Scott Health Sciences Library, University of Alberta, 2K3.28 Walter C. Mackenzie Health Sciences Centre, Edmonton, Alberta, T6G 2R7, Canada
| | - Allison Gates
- Alberta Research Centre for Health Evidence (ARCHE), Department of Pediatrics, University of Alberta, 4-482C, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada
| | - Shelly Jun
- Department of Surgery, University of Alberta, 3E1.14 Walter Mackenzie Centre, 8440-112 Street, Edmonton, Alberta, T6G 2B7, Canada
| | - Brian L Brooks
- Neurosciences program, Alberta Children's Hospital, Calgary, Canada
- Departments of Pediatrics, Clinical Neurosciences, and Pediatrics, University of Calgary, Calgary, Canada
- Alberta Children's Research Institute, University of Calgary, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada
| | - Meghan Sebastianski
- Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, University of Alberta, 4-486D, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada
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Haines C, Loades M, Davis C. Illness perceptions in adolescents with chronic fatigue syndrome and other physical health conditions: Application of the common sense model. Clin Child Psychol Psychiatry 2019; 24:546-563. [PMID: 30770020 PMCID: PMC7100035 DOI: 10.1177/1359104519829796] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The common sense model (CSM) proposes that illness perceptions guide coping and illness management, which subsequently affects outcomes. Chronic fatigue syndrome (CFS) is associated with severe functional impairment. CFS is distinct from other physical health conditions in that individuals can experience high levels of uncertainty, stigma and disbelief from others. This study aimed to compare illness perceptions in adolescents with CFS with other physical health conditions, using a cross-sectional, between-groups design. METHODS Adolescents (aged 11-18) with CFS (n = 49), type 1 diabetes (n = 52) and juvenile idiopathic arthritis (n = 42) were recruited through National Health Service (NHS) clinics and online, and completed a series of questionnaires. RESULTS Adolescents with CFS differed on the perceived consequences, timeline, personal control, treatment control, identity and understanding dimensions of illness perceptions. Except for identity, these dimensions were predicted by health condition even when accounting for age, gender, fatigue, physical functioning, anxiety and depression. CONCLUSIONS Results offer preliminary evidence for the applicability of the CSM in adolescents, with implications for supporting adolescents with physical health conditions. Results suggest that psychological interventions targeting perceived control, understanding and identity may have particular utility for adolescents with CFS.
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Affiliation(s)
- Cara Haines
- 1 Department of Psychology, University of Bath, UK
| | - Maria Loades
- 1 Department of Psychology, University of Bath, UK.,2 Bristol Medical School, University of Bristol, UK
| | - Cara Davis
- 1 Department of Psychology, University of Bath, UK
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Pateraki E, Vance Y, Morris PG. The Interaction Between Asthma and Anxiety: An Interpretative Phenomenological Analysis of Young People's Experiences. J Clin Psychol Med Settings 2019; 25:20-31. [PMID: 29322289 DOI: 10.1007/s10880-017-9528-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Asthma and anxiety are highly co-morbid, and their interaction leads to exacerbations for both conditions. This study explored the interplay between these two conditions from the perspective of children and adolescents. The objective was to identify potential mechanisms of interaction between asthma and anxiety, and to derive improvements for prevention and treatment. Eleven semi-structured interviews of young people (aged 11-15), who met criteria for both asthma and anxiety, were analysed using interpretative phenomenological analysis. Well-established qualitative research recommendations were followed to promote credibility and rigour in the findings. Eight themes emerged that were organised in three domains: (i) asthma affecting anxiety by inhibiting coping activities or developmental tasks and by triggering unhelpful thinking and behaviour; (ii) anxiety affecting asthma by impairing self-care and triggering hyperventilation; (iii) interactions between asthma and anxiety, including self-perpetuating feedback cycles and symptom confusion. The proposed mechanisms could help tailor cognitive-behavioural interventions to reduce anxiety and asthma complications.
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Affiliation(s)
- Eleni Pateraki
- Paediatric Psychology Service, Wishaw General Hospital, NHS Lanarkshire, Wishaw, ML2 0DP, Scotland, UK.
| | - Yvonne Vance
- Paediatric Psychology Service, Wishaw General Hospital, NHS Lanarkshire, Wishaw, ML2 0DP, Scotland, UK
| | - Paul Graham Morris
- Clinical and Health Psychology Department, University of Edinburgh, Edinburgh, Scotland, UK
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Booster GD, Oland AA, Bender BG. Psychosocial Factors in Severe Pediatric Asthma. Immunol Allergy Clin North Am 2017; 36:449-60. [PMID: 27401618 DOI: 10.1016/j.iac.2016.03.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Asthma is the most common chronic illness among children in the United States and can impact nearly all aspects of functioning. Most research suggests that children with severe asthma display more emotional and behavioral problems than their healthy peers. These psychological difficulties are associated with increased risk for functional impairments and problematic disease course. Multidisciplinary teams that assess and treat these psychosocial factors using psychoeducational and behavioral interventions are important for children whose asthma is poorly controlled. Future research should examine the ways in which stress, emotions, and immune functions interact, so as to develop more preventative interventions.
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Affiliation(s)
- Genery D Booster
- Pediatric Behavioral Health, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
| | - Alyssa A Oland
- Pediatric Behavioral Health, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA
| | - Bruce G Bender
- Pediatric Behavioral Health, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA
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MacNeil J, Loves RH, Aaron SD. Addressing the misdiagnosis of asthma in adults: where does it go wrong? Expert Rev Respir Med 2016; 10:1187-1198. [PMID: 27677224 DOI: 10.1080/17476348.2016.1242415] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Asthma is diagnosed based on patients' respiratory symptoms of wheeze, cough, chest tightness and/or dyspnea together with physiologic evidence of variable and reversible expiratory airflow limitation. A high prevalence of overdiagnosis, underdiagnosis and misdiagnosis of adult asthma has been reported in the literature. Areas covered: Misdiagnosis of asthma in adults can occur in the community due to physicians' failure to confirm airflow limitation using spirometry, the relatively poor sensitivity of spirometry to absolutely rule in asthma, the complexity of multiple asthma phenotypes and endotypes, and the inherent day to day variability of asthma symptoms and airflow limitation. Consequences of asthma misdiagnosis to the patient and to the healthcare system include increased medication costs, increased potential side effects related to unnecessary use of medications and lost opportunities to diagnose the true cause of patients' respiratory symptoms. Expert commentary: Here we provide a review of the problem of misdiagnosis of adult asthma and suggestions for how to decrease the risk of misdiagnosis.
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Affiliation(s)
- Jenna MacNeil
- a Department of Medicine , The Ottawa Hospital Research Institute, University of Ottawa , Ottawa , Canada
| | - Robyn H Loves
- a Department of Medicine , The Ottawa Hospital Research Institute, University of Ottawa , Ottawa , Canada
| | - Shawn D Aaron
- a Department of Medicine , The Ottawa Hospital Research Institute, University of Ottawa , Ottawa , Canada
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12
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Mental and physical health outcomes following the Relaxation Response Resiliency Program (3RP) in a clinical practice setting. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2016.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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13
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Broadbent E, Wilkes C, Koschwanez H, Weinman J, Norton S, Petrie KJ. A systematic review and meta-analysis of the Brief Illness Perception Questionnaire. Psychol Health 2015; 30:1361-85. [DOI: 10.1080/08870446.2015.1070851] [Citation(s) in RCA: 282] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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14
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Heyduck K, Meffert C, Glattacker M. Illness and treatment perceptions of patients with chronic low back pain: characteristics and relation to individual, disease and interaction variables. J Clin Psychol Med Settings 2015; 21:267-81. [PMID: 25100026 DOI: 10.1007/s10880-014-9405-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The significance of various cognitive and psychosocial factors in the development, progression and persistence of chronic low back pain (CLBP) is well demonstrated. However, only a few studies have addressed CLBP patients' cognitive representations or beliefs about their disease and its treatment. The present study aimed to: (1) describe the illness and treatment beliefs of patients with CLBP, e.g., expected timeline, controllability or treatment related concerns; and (2) explore the relation of these illness and treatment beliefs to individual-, disease- and interaction-related variables. We conducted a cross-sectional survey with N = 201 patients at four inpatient rehabilitation centers. The characteristics of illness and treatment perceptions were analyzed using descriptive statistics. Multiple regression analysis was used to test the associations with disease-related, individual-related and interaction-related variables. The results demonstrated large inter-individual variability in the illness and treatment perceptions among patients with CLBP and pointed to several associations with disease-related variables, patients' personal characteristics and interaction experiences. The variables most strongly related to individuals' perceptions were those reflecting disease severity and individual disease experience. Further research is needed on CLBP patients' illness and treatment perceptions, and these personal disease experiences should be considered when designing new treatment approaches.
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Affiliation(s)
- Katja Heyduck
- Institute for Quality Management and Social Medicine, Medical Center - University of Freiburg, Engelbergerstraße 21, 79106, Freiburg, Germany,
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15
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Panzaru GM, Holman A. Type of treatment of cardiac disorders – quality of life and heart-focused anxiety: The mediating role of illness perceptions. PSYCHOL HEALTH MED 2014; 20:551-9. [DOI: 10.1080/13548506.2014.989863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Patil SP, Liu C, Alban J, Yang N, Li XM. Glycyrrhiza uralensis flavonoids inhibit brain microglial cell TNF-α secretion, p-IκB expression, and increase brain-derived neurotropic factor (BDNF) secretion. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2014. [DOI: 10.1016/j.jtcms.2014.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Goodwin RD, Hottinger K, Pena L, Chacko A, Feldman J, Wamboldt MZ, Hoven C. Asthma and mental health among youth in high-risk service settings. J Asthma 2014; 51:639-44. [PMID: 24628526 DOI: 10.3109/02770903.2014.897728] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate the prevalence of asthma and mental health problems among representative samples of youth in high-risk service settings and the community, and to examine the relationship between asthma and mental health in these groups. METHODS Data were drawn from the Alternative Service Use Patterns of Youth with Serious Emotional Disturbance Study (SED) (n = 1181), a combined representative, cross-sectional sample of youth in various clinical settings and the community. Multiple logistic regression analyses were used to examine the association between asthma and mental disorders. Demographic characteristics were investigated as potential confounders. RESULTS Asthma was common among 15.2% of youth in service settings and 18.8% of youth in the community. The prevalence of mental disorders was extremely high among youth with and without asthma in all service settings, and asthma was associated with increased prevalence of mental disorders among youth in the community, but not among youth in service settings. The relationship between asthma and internalizing disorders among youth in the community does not appear entirely attributable to confounding by demographics. CONCLUSIONS Findings are consistent with and extend previous data by showing that both asthma and mental disorders are disproportionately common among youth in high-risk service settings. Almost half of youth with asthma in service settings meet diagnostic criteria for a mental disorder. Clinicians and policy makers who are responsible for the health care of youth in these high-risk groups should be aware that asthma is common, and that the prevalence of internalizing disorders are especially common among those with asthma.
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Affiliation(s)
- Renee D Goodwin
- Department of Psychology, Queens College, City University of New York (CUNY) , NY , USA
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Luberto CM, Yi MS, Tsevat J, Leonard AC, Cotton S. Complementary and alternative medicine use and psychosocial outcomes among urban adolescents with asthma. J Asthma 2012; 49:409-15. [PMID: 22715868 DOI: 10.3109/02770903.2012.672612] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective. Many adolescents with asthma use complementary and alternative medicine (CAM) for asthma symptom management. The purpose of this study was to investigate cross-sectional and longitudinal differences in psychosocial health outcomes between high and low CAM users among urban adolescents with asthma. Methods. Adolescents (Time 1: N = 151, Time 2: N = 131) completed self-report measures regarding the use of 10 CAM modalities, mental health, and health-related quality of life (HRQoL) following two clinic visits 1 year apart as part of a larger observational study. Multivariable regression analyses using backward elimination examined relationships between CAM use at Time 1 and outcomes at Time 1 and Time 2, controlling for key covariates and, in longitudinal analyses, Time 1 functioning. Results. Participants (M(age) = 15.8, SD = 1.85) were primarily African-American (n = 129 [85%]) and female (n = 91 [60%]) adolescents with asthma. High and low CAM users differed significantly in terms of several psychosocial health outcomes, both cross-sectionally and longitudinally. In cross-sectional multivariable analyses, greater frequency of praying was associated with better psychosocial HRQoL (R(2) = 0.22). No longitudinal relationships remained significant in multivariable analyses. Conclusions. Specific CAM techniques are differentially associated with psychosocial outcomes, indicating the importance of examining CAM modalities individually. Greater frequency of praying was cross-sectionally associated with better psychosocial HRQoL. When controlling for key covariates, CAM use was not associated with psychosocial outcomes over time. Further research should examine the effects of CAM use in controlled research settings.
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Affiliation(s)
- Christina M Luberto
- Department of Psychology, University of Cincinnati, Cincinnati, OH 45267-0840, USA
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Holgate ST. The importance of primary care research in the management of respiratory disease. PRIMARY CARE RESPIRATORY JOURNAL : JOURNAL OF THE GENERAL PRACTICE AIRWAYS GROUP 2012; 21:1-3. [PMID: 22349919 DOI: 10.4104/pcrj.2012.00015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Li XM. Treatment of asthma and food allergy with herbal interventions from traditional chinese medicine. ACTA ACUST UNITED AC 2012; 78:697-716. [PMID: 21913200 DOI: 10.1002/msj.20294] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Prevalence of asthma and allergy has increased over the past 2-3 decades in Westernized countries. Despite increased understanding of the pathogenesis of asthma and allergic diseases, control of severe asthma is still difficult. Asthma is also associated with a high prevalence of anxiety, particularly in adolescents. There is no effective treatment for food allergy. Food allergy is often associated with severe and recalcitrant eczema. Novel approaches for treatment of asthma and food allergy and comorbid conditions are urgently needed. Traditional Chinese medicine, used in Asia for centuries, is beginning to play a role in Western healthcare. There is increasing scientific evidence supporting the use of traditional Chinese medicine for asthma treatment. Since 2005, several controlled clinical studies of "antiasthma" herbal remedies have been published. Among the herbal medicines, antiasthma herbal medicine intervention is the only antiasthma traditional Chinese medicine product that is a Food and Drug Administration investigational new drug that has entered clinical trials in the United States. Research into the effects and mechanisms of action of antiasthma herbal medicine intervention in animal models is actively being pursued. Research on traditional Chinese medicine herbal medicines for treating food allergy is rare. The herbal intervention Food Allergy Herbal Formula-2 is the only Food and Drug Administration botanical investigational new drug under investigation as a multiple food allergy therapy. This review article discusses promising traditional Chinese medicine interventions for asthma, food allergy, and comorbid conditions, and explores their possible mechanisms of action.
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Affiliation(s)
- Xiu-Min Li
- Department of Pediatric Allergy and Immunology, Mount Sinai School of Medicine, New York, NY, USA.
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Weekes JC, Cotton S, McGrady ME. Predictors of substance use among black urban adolescents with asthma: a longitudinal assessment. J Natl Med Assoc 2011; 103:392-8. [PMID: 21809788 DOI: 10.1016/s0027-9684(15)30335-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The physical and psychological consequences of asthma, a chronic respiratory disease disproportionately affecting black urban adolescents, may be amplified by substance use, yet studies have not assessed rates or predictors of substance use in this at-risk population. Therefore, this study examined rates of substance use and mental health/ asthma-related predictors of use among 110 black urban adolescents with asthma. Participants completed study questionnaires at baseline and 11 to 14 months post baseline. The mean age of the sample was 15.8 (SD +/- 1.85), 66 (60%) were female, and 82 (74%) of the participants had intermittent/mild persistent asthma. At follow-up, 37 (34%) participants endorsed using at least 1 substance in the past 30 days, including cannabis (n = 18 [16%]), cigarettes (n = 13 [12%]), and/or alcohol (n = 23 [21%]). The substance use variables were dichotomized for analyses (1 = use, 0 = nonuse). Logistic regression results indicated that older age (odds ratio [OR], 1.83; p < .05) was significantly associated with cigarette use and had a marginally significant (p = .06) association with cannabis use at follow-up. Increased anxiety symptoms were significantly associated with alcohol use (OR, 1.12; p < .05) and cannabis use (OR, 0.90; p < .05) at follow-up. Targeting adolescents earlier, those with anxiety difficulties, and those who report early substance initiation may improve prevention/intervention efforts for substance use reduction in this population. Asthma-related factors were not significantly associated with substance use. Future studies should assess the relationship between other asthma-related variables, as well as social and community factors, and substance use among black adolescents with asthma.
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Affiliation(s)
- Jerren C Weekes
- Department of Psychology, College of Medicine, University of Cincinnati, Cincinnati, OH 45221-0376, USA.
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Cotton S, Luberto CM, Yi MS, Tsevat J. Complementary and alternative medicine behaviors and beliefs in urban adolescents with asthma. J Asthma 2011; 48:531-8. [PMID: 21504264 DOI: 10.3109/02770903.2011.570406] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND/PURPOSE Up to 80% of adolescents with asthma have used complementary and alternative medicine (CAM) for symptom management. However, little is known about patient characteristics associated with CAM factors other than use. Previous studies recommend provider-patient discussion of CAM use, although few adolescents with asthma disclose their CAM use to their providers. To inform clinical interactions, this study examined prevalence and predictors of CAM use, consideration of use, disclosure of use, and perceived efficacy of use, in urban adolescents with asthma. METHODS Adolescents with asthma (N = 151) recruited from a children's hospital completed questionnaires addressing demographic and clinical variables and 10 CAM modalities. Response frequencies to four questions assessing CAM use, consideration of use, disclosure, and perceived efficacy were calculated for each modality. Multivariable logistic regression analyses examined characteristics associated with responses to each question for the two most commonly used CAM modalities. RESULTS Participants' mean age was 15.8 (SD = 1.8), 60% were female and 85% were African-American. Seventy-one percent reported using CAM for symptom management in the past month. Relaxation (64%) and prayer (61%) were the most frequently reported modalities and were perceived to be the most efficacious. Adolescents most commonly reported considering using relaxation (85%) and prayer (80%) for future symptom management. Participants were most likely to disclose their use of yoga (59%) and diet (57%), and least likely to disclose prayer (33%) and guided imagery (36%) to providers. In multivariable analyses, older adolescents (OR = 1.27, p < .05) and African-Americans (OR = 2.76, p < .05) were more likely to use relaxation. Adolescents with more frequent asthma symptoms (OR = 0.98, p < .05) were more likely to use prayer. African-Americans were more likely to report using prayer (OR = 3.47, p < .05) and consider using prayer (OR = 7.98, p < .01) in the future for symptom management. CONCLUSIONS Many urban adolescents used and would consider using CAM, specifically relaxation and prayer, for asthma symptom management. African-Americans, older adolescents, and those with more frequent symptoms were more likely to use and/or consider using CAM. Providers caring for urban adolescents with asthma should discuss CAM with patients, particularly those identified as likely to use CAM. Future studies should examine relationships between CAM use and health outcomes.
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Affiliation(s)
- Sian Cotton
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0840, USA.
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