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Kotsiou OS, Barkas GI, Kokkinidou K, Siachpazidou DI, Gourgoulianis KI, Daniil Z. Psychopathology in Asthma Patients: Analysis of Demographic and Clinical Associations. J Asthma 2024:1-18. [PMID: 39230207 DOI: 10.1080/02770903.2024.2400601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 08/29/2024] [Accepted: 08/30/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND Asthma, a chronic inflammatory condition affecting the airways, significantly impacts both respiratory function and quality of life. Recent studies have highlighted the psychological dimensions of chronic diseases like asthma. Despite growing evidence linking asthma with various psychopathological conditions, comprehensive data remains scarce. AIM This study aims to explore the psychopathological status of asthma patients and identify demographic and clinical factors associated with higher levels of psychopathological symptoms. METHODS Data were collected from 42 asthma patients attending the Asthma Outpatient Clinic at the University of Thessaly, Greece. Participants completed a detailed questionnaire on demographics and clinical parameters, along with the Symptoms Checklist-90 (SCL-90) to assess psychological symptoms. RESULTS The sample included patients with varying asthma severity: 38% with severe asthma and 62% with mild-moderate asthma, with a mean age of 60.8 ± 15.6 years. Results indicated that 23.8% exhibited somatization symptoms, 23.8% showed compulsive behaviors, 33.8% reported interpersonal sensitivity, and 38.1% experienced depression and 38.1% aggressiveness. Additionally, 45.2% struggled with fearful anxiety, 4.8% showed paranoid ideation, and 11.9% had traits of psychoticism. Women had significantly higher psychopathology scores than men. Factors such as longer disease duration, uncontrolled asthma, severe asthma, and comorbid conditions like atopy and gastroesophageal reflux disease (GERD) were linked to higher psychopathological scores. CONCLUSIONS The study found a high prevalence of psychopathological symptoms among asthma patients. Female gender, prolonged asthma duration, persistent symptoms, comorbid diseases (GERD, atopy) and greater disease severity were significantly associated with higher psychopathology, underscoring the need for integrated mental health care in asthma management.
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Affiliation(s)
- Ourania S Kotsiou
- Laboratory of Human Pathophysiology, Department of Nursing, University of Thessaly School of Health Sciences, 45550 Gaiopolis, Greece
- Department of Nursing, University of Thessaly, 45550 Gaiopolis, Greece
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly School of Health Sciences, 41100 Biopolis, Greece
| | - Georgios I Barkas
- Laboratory of Human Pathophysiology, Department of Nursing, University of Thessaly School of Health Sciences, 45550 Gaiopolis, Greece
- Department of Nursing, University of Thessaly, 45550 Gaiopolis, Greece
| | - Katerina Kokkinidou
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly School of Health Sciences, 41100 Biopolis, Greece
| | - Dimitra I Siachpazidou
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly School of Health Sciences, 41100 Biopolis, Greece
| | - Konstantinos I Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly School of Health Sciences, 41100 Biopolis, Greece
| | - Zoe Daniil
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly School of Health Sciences, 41100 Biopolis, Greece
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Surve TAN, Sharma DD, Khan KG, Ghanie N, Charanrak R, Sharifa M, Begum S, Auz MJ, Akbarova N, Mylavarapu M. A comprehensive review of the intersection between asthma and depression. J Asthma 2024; 61:895-904. [PMID: 38415695 DOI: 10.1080/02770903.2024.2324862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/16/2024] [Accepted: 02/25/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE To emphasize the necessity for increased research in this field, incorporating depression into the preventative, diagnostic, and therapeutic considerations for asthma. Additionally, we seek to highlight upcoming advancements that can be applied to simultaneously address these comorbidities, ultimately improving the overall well-being and quality of life for individuals coping with these conditions. METHODS A rigorous search in PubMed using the MeSH terms "asthma" and "depression" was performed, and papers were screened by the authors in view of their eligibility to contribute to the study. RESULTS There exists a correlation between these two conditions, with specific biological mechanisms and genetic factors playing a crucial role in their concurrent occurrence. In this review, we present preclinical and clinical research data, shed light on the possible mechanisms contributing to the co-occurrence of symptoms associated with both asthma and depression, and explore the intricate relationship between both conditions. CONCLUSION The evidence presented here supports the existence of a correlation between asthma and depression. By acknowledging these shared biological mechanisms, genetic factors, and epidemiological trends, we can formulate more efficacious strategies for addressing the dual impact of asthma and depression.
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Affiliation(s)
| | - DhruviKumari D Sharma
- Department of Internal Medicine, Spartan Health Sciences University, Vieux Fort, Saint Lucia
| | - Kiyan Ghani Khan
- Department of Internal Medicine, Baqai Medical University, Karachi, Pakistan
| | - Neisha Ghanie
- Department of Internal Medicine, American University of Antigua, Osbourn, Antigua and Barbuda
| | - Riley Charanrak
- Department of Internal Medicine, University of Lublin, Lublin, Poland
| | - Mouhammad Sharifa
- Department of Internal Medicine, University of Aleppo Faculty of Medicine, Aleppo, Syria
| | - Samreen Begum
- Department of Internal Medicine, Deccan College of Medical Sciences, Hyderabad, India
| | - Maria Jose Auz
- Department of Internal Medicine, Pontificia Universidad Catolica Argentina, Buenos Aires, Argentina
| | - Nozima Akbarova
- Department of Internal Medicine, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
| | - Maneeth Mylavarapu
- Graduate Research Assistant, Department of Public Health, Adelphi University, Garden City, NY, USA
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Ruppe NM, Clawson AH, Nwankwo CN, Blair AL. Longitudinal Associations Between Depression and Religiosity/Spirituality Among Individuals with Asthma in the United States. JOURNAL OF RELIGION AND HEALTH 2024; 63:2963-2980. [PMID: 37665416 DOI: 10.1007/s10943-023-01903-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/05/2023]
Abstract
There is limited literature examining the longitudinal stability of depressive symptoms for individuals with asthma, or how religiosity/spirituality relates to depressive symptoms across time. The present study aimed to identify the stability of and the longitudinal associations between depressive symptoms and R/S across multiple developmental periods for adolesents with asthma (N = 998) within the United States. Depressive symptoms (βrange 0.33 - 0.60) and R/S (βrange 0.26 - 0.73) were stable across time, with some variability. A cross-lagged association demonstrated that use of R/S in young adulthood (Wave 3) was associated with decreased depressive symptoms in adulthood (β = -0.17, p < .001, CI - 0.25 - - 0.09, SE = 0.04). Use of R/S in adolescence (Wave 2) was predictive of increased depression in adulthood (β = 0.13, p < .001, CI 0.05 - 0.20, SE = 0.04). Results demonstrated differential relations between R/S and depressive symptoms across development, and highlight the potential importance of integrating conversations focused on R/S within healthcare settings, especially as R/S during young adulthood may buffer against or reduce depressive symptoms in adulthood.
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Affiliation(s)
- Nicole M Ruppe
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA.
- Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, USA.
- Center for Healthcare Delivery Science, Nemours Children's Hospital, Wilmington, DE, 19803, USA.
| | - Ashley H Clawson
- Center for the Study of Tobacco, Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham St., #820, Little Rock, AR, 72205, USA
| | - Cara N Nwankwo
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
- Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Alexandra L Blair
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
- Center for Pediatric Psychology, Oklahoma State University, Stillwater, OK, USA
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4
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Xu H, Pan M, Zhu L. Effect of nursing intervention on rehabilitation of patients with chronic sinusitis and nasal polyps after nasal endoscopy. World J Clin Cases 2024; 12:3785-3790. [PMID: 38994292 PMCID: PMC11235459 DOI: 10.12998/wjcc.v12.i19.3785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/30/2024] [Accepted: 05/20/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa. Nasal endoscopy is a good method to treat nasal polyps. However postoperative rehabilitation and care should not be neglected. AIM To investigate the Effect of nursing intervention on the rehabilitation of patients with chronic sinusitis and nasal polyps (CSNPS) after nasal endoscopy. METHODS A total of 129 patients with CSNPS hospitalized from February 2017 to February 2019 were studied. Using the digital parity method, we investigated nursing cooperation strategies for endoscopic surgery. The comparison group (64 cases): Surgical nursing was carried out with traditional nursing measures; experimental group (65 cases): Surgical nursing was carried out by traditional nursing countermeasures + comprehensive nursing measures. We compared postoperative recovery rates, nursing satisfaction rates, and nasal cavity ratings between the two groups. RESULTS Experimental group patients with CSNPS had a significantly higher recovery rate (98.46%) compared to the control group (79.69%). This difference was statistically significant (χ 2 = 11.748, P < 0.05). Additionally, the satisfaction rate with treatment was also significantly higher in the experimental group (98.46%) compared to the control group (79.69%), with a statistically significant difference (χ 2 = 11.748, P < 0.05). Before nursing, there was no significant difference in sinus nasal cavity scores between the experimental group (20.29 ± 7.25 points) and the control group (20.30 ± 7.27 points) (t = 0.008, P > 0.05). However, after nursing, the sinus nasal cavity score in the experimental group (8.85 ± 3.22 points) was significantly lower than that in the control group (14.99 ± 5.02 points) (t = 8.282, P < 0.05). CONCLUSION Comprehensive nursing intervention in patients with CSNPS can significantly improve the total recovery rate after endoscopic surgery.
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Affiliation(s)
- Hui Xu
- Department of Otolaryngology, The First People’s Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China
| | - Miao Pan
- Department of Otolaryngology, The First People’s Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China
| | - Lin Zhu
- Department of Otolaryngology, The First People’s Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China
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Fleischer NJ, Gosch E, Roberts MB, Albano AM, Ginsburg G, Piacentini J, Birmaher B, Compton SN, Walkup J, Kendall PC, Carper MM. Asthma and anxiety in children and adolescents: characteristics and treatment outcomes. J Asthma 2024; 61:396-404. [PMID: 37930754 DOI: 10.1080/02770903.2023.2280906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/02/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE This study (a) examined anxious youth with and without asthma on measures of negative self-talk, parental psychopathology, worry content, physical symptoms, panic symptoms, generalized symptoms, and separation anxiety symptoms, and (b) tested if outpatient CBT or medication were differentially effective in reducing anxiety for youth with asthma and anxiety. METHODS This secondary analysis separated youth with an anxiety disorder into asthma and non-asthma groups. Youth were also compared on response to treatments (i.e. CBT, sertraline, combined, and placebo). RESULTS A total of 488 participants participated in the original study, with an average age of 10 years (SD 2.87). Youth with comorbid asthma and anxiety demonstrated higher rates of negative self-talk. Youth with comorbid asthma and anxiety did not differ from the non-asthma group on measures of physical symptoms, anxiety disorder specific symptoms, parental psychopathology, or worry content. Youth with asthma and anxiety responded similarly to the non-asthma group to treatment across treatment conditions. CONCLUSIONS Treatment was comparably effective for youth with comorbid asthma and anxiety and youth with anxiety. Future research could examine the effects of psychopharmaceuticals on asthma and anxiety comorbidity.
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Affiliation(s)
- Nicole J Fleischer
- Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, PA, USA
| | - Elizabeth Gosch
- School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Michael B Roberts
- School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | | | - Golda Ginsburg
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - John Piacentini
- Department of Psychiatry, UCLA School of Medicine, Los Angeles, CA, USA
| | - Boris Birmaher
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - John Walkup
- Department of Psychiatry, Lurie Children's Hospital, Chicago, IL, USA
| | - Philip C Kendall
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Matthew M Carper
- Department of Clinical Psychology, William James College, Newton, MA, USA
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Bischops AC, Sieper L, Dukart J, Schaal NK, Reinauer C, Oommen PT, Tomoiaga C, David O, Mayatepek E, Meissner T. Resilience strengthening in youth with a chronic medical condition: a randomized controlled feasibility trial of a combined app and coaching program. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02395-w. [PMID: 38431540 DOI: 10.1007/s00787-024-02395-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/11/2024] [Indexed: 03/05/2024]
Abstract
Youth with a chronic medical condition (CMC) are often affected by comorbid mental disorders. Resilience-strengthening interventions can protect youth's mental health, yet evidence-based programs remain scarce. To address this lack, this study aimed to evaluate the feasibility of a dual approach combining app-based resilience training and cognitive behavioral group coaching. Fifty-one youths with CMC treated at a German university children's hospital aged 12-16 years were recruited. They were randomly assigned to a combined app game and coaching intervention or sole app gameplay. At pre-, post-intervention, and at a 2-month follow-up resilience, automatic negative thoughts and an app and coaching evaluation were assessed. Feasibility was defined as a recruitment rate of 70%, an 85% adherence rate for the REThink game, and 70% participation in both coaching sessions. Feasibility criteria were reached for coaching participation but not for recruitment or app adherence. While both the REThink game app and coaching intervention had high acceptance rates among youth with CMC, participants receiving additional coaching sessions showed higher satisfaction and adherence rates. Participants preferred remote to in-person meetings. The findings support a combination of a gamification app approach with online group coaching. Group coaching can improve adherence while online options increase accessibility. Future research should focus on testing in diverse participant samples, language, and age-adapted updates of the REThink game app. These findings provide guidance for increasing adherence in future intervention studies in youth with CMC cohorts.
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Affiliation(s)
- Anne Christine Bischops
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany.
| | - L Sieper
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - J Dukart
- Institute for Neurosciences and Medicine: Brain and Behavior (INM-7), Research Center Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - N K Schaal
- Department of Experimental Psychology, Heinrich Heine University, Düsseldorf, Germany
| | - C Reinauer
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - P T Oommen
- Division of Pediatric Rheumatology, Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - C Tomoiaga
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babes-Bolyai University, Cluj-Napoca, Romania
| | - O David
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babes-Bolyai University, Cluj-Napoca, Romania
| | - E Mayatepek
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - T Meissner
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Moorenstrasse 5, 40225, Düsseldorf, Germany
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Sharrad KJ, Sanwo O, Cuevas-Asturias S, Kew KM, Carson-Chahhoud KV, Pike KC. Psychological interventions for asthma in children and adolescents. Cochrane Database Syst Rev 2024; 1:CD013420. [PMID: 38205864 PMCID: PMC10782779 DOI: 10.1002/14651858.cd013420.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
BACKGROUND Rates of asthma are high in children and adolescents, and young people with asthma generally report poorer health outcomes than those without asthma. Young people with asthma experience a range of challenges that may contribute to psychological distress. This is compounded by the social, psychological, and developmental challenges experienced by all people during this life stage. Psychological interventions (such as behavioural therapies or cognitive therapies) have the potential to reduce psychological distress and thus improve behavioural outcomes such as self-efficacy and medication adherence. In turn, this may reduce medical contacts and asthma attacks. OBJECTIVES To determine the efficacy of psychological interventions for modifying health and behavioural outcomes in children with asthma, compared with usual treatment, treatment with no psychological component, or no treatment. SEARCH METHODS We searched the Cochrane Airways Group Specialised Register (including CENTRAL, CRS, MEDLINE, Embase, PsycINFO, CINAHL EBSCO, AMED EBSCO), proceedings of major respiratory conferences, reference lists of included studies, and online clinical databases. The most recent search was conducted on 22 August 2022. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing psychological interventions of any duration with usual care, active controls, or a waiting-list control in male and female children and adolescents (aged five to 18 years) with asthma. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were 1. symptoms of anxiety and depression, 2. medical contacts, and 3. asthma attacks. Our secondary outcomes were 1. self-reported asthma symptoms, 2. medication use, 3. quality of life, and 4. adverse events/side effects. MAIN RESULTS We included 24 studies (1639 participants) published between 1978 and 2021. Eleven studies were set in the USA, five in China, two in Sweden, three in Iran, and one each in the Netherlands, UK, and Germany. Participants' asthma severity ranged from mild to severe. Three studies included primary school-aged participants (five to 12 years), two included secondary school-aged participants (13 to 18 years), and 18 included both age groups, while one study was unclear on the age ranges. Durations of interventions ranged from three days to eight months. One intervention was conducted online and the rest were face-to-face. Meta-analysis was not possible due to clinical heterogeneity (interventions, populations, outcome tools and definitions, and length of follow-up). We tabulated and summarised the results narratively with reference to direction, magnitude, and certainty of effects. The certainty of the evidence was very low for all outcomes. A lack of information about scale metrics and minimal clinically important differences for the scales used to measure anxiety, depression, asthma symptoms, medication use, and quality of life made it difficult to judge clinical significance. Primary outcomes Four studies (327 participants) reported beneficial or mixed effects of psychological interventions versus controls for symptoms of anxiety, and one found little to no difference between groups (104 participants). Two studies (166 participants) that evaluated symptoms of depression both reported benefits of psychological interventions compared to controls. Three small studies (92 participants) reported a reduction in medical contacts, but two larger studies (544 participants) found little or no difference between groups in this outcome. Two studies (107 participants) found that the intervention had an important beneficial effect on number of asthma attacks, and one small study (22 participants) found little or no effect of the intervention for this outcome. Secondary outcomes Eleven studies (720 participants) assessed asthma symptoms; four (322 participants) reported beneficial effects of the intervention compared to control, five (257 participants) reported mixed or unclear findings, and two (131 participants) found little or no difference between groups. Eight studies (822 participants) reported a variety of medication use measures; six of these studies (670 participants) found a positive effect of the intervention versus control, and the other two (152 participants) found little or no difference between the groups. Across six studies (653 participants) reporting measures of quality of life, the largest three (522 participants) found little or no difference between the groups. Where findings were positive or mixed, there was evidence of selective reporting (2 studies, 131 participants). No studies provided data related to adverse effects. AUTHORS' CONCLUSIONS Most studies that reported symptoms of anxiety, depression, asthma attacks, asthma symptoms, and medication use found a positive effect of psychological interventions versus control on at least one measure. However, some findings were mixed, it was difficult to judge clinical significance, and the evidence for all outcomes is very uncertain due to clinical heterogeneity, small sample sizes, incomplete reporting, and risk of bias. There is limited evidence to suggest that psychological interventions can reduce the need for medical contact or improve quality of life, and no studies reported adverse events. It was not possible to identify components of effective interventions and distinguish these from interventions showing no evidence of an effect due to substantial heterogeneity. Future investigations of evidence-based psychological techniques should consider standardising outcomes to support cross-comparison and better inform patient and policymaker decision-making.
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Affiliation(s)
- Kelsey J Sharrad
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
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Ruppe NM, Clawson AH, Ankney RL, Welch G, Mullins LL, Chaney JM. Depressive Symptom Trajectories Across Adolescence and Adulthood Among Individuals With Asthma. J Pediatr Psychol 2023; 48:572-582. [PMID: 37130344 PMCID: PMC10321385 DOI: 10.1093/jpepsy/jsad022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVE Individuals with asthma experience increased depressive symptoms, which is associated with deleterious health outcomes. No studies have examined depressive symptom trajectories among individuals with asthma despite increased risk. This study expanded prior literature by identifying the following: (1) depressive symptoms trajectories for individuals with and without asthma and (2) predictors of baseline levels and changes in symptoms across time for individuals with asthma. METHODS Adolescents with (N = 965) and without (N = 7,392) asthma self-reported on depressive symptoms (CESD-9) across development. Covariates included: demographics and persistence of asthma. Latent growth curve modeling (LGCM) was used to identify depressive symptom trajectories and their predictors. RESULTS A multigroup LCGM identified no significant differences between depressive symptom trajectories of individuals with and without asthma. Depressive symptoms followed a quadratic shape across time for individuals with asthma (Mintercept = 5.73, p < .00; Mlinear = -0.38,p < .001; Mquad = 0.03, p < .001), with a linear deceleration in depressive symptoms during adolescence and an acceleration of symptoms into adulthood. Next predictors of depressive trajectories among individuals with asthma were examined. Female sex (B = 0.58, p < .001), lower parent education (B = -0.57, p < .001), older age (B = 0.19, p < .001), and identifying as Black (B = 0.31, p = .04) were associated with greater baseline depressive symptoms. Older individuals exhibited faster linear symptom decelerations (B = -0.56, p < .001) and faster symptom accelerations (B = 0.73, p < .001). American Indian (AIAN) individuals exhibited faster linear symptom decelerations (B = -1.98, p = .005) and faster quadratic accelerations (B = 3.33, p = .007). DISCUSSION Our results suggest that the depressive symptom trajectories of individuals with asthma are curvilinear and similar to individuals without asthma. When examining predictors of depressive symptom trajectories for those with asthma, socioeconomic disadvantage and racial marginalization were associated with greater baseline depressive symptoms. Although AIAN youth demonstrated more favorable trajectories in adolescence, they also exhibited worse trajectories across young adulthood and adulthood. Findings suggest the need to better understand the impact of multilevel risk and protective factors on depressive symptoms trajectories for individuals with asthma, especially marginalized populations.
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Affiliation(s)
- Nicole M Ruppe
- Department of Psychology, Oklahoma State University, USA
- Center for Pediatric Psychology, Oklahoma State University, USA
| | - Ashley H Clawson
- Center for the Study of Tobacco, Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham St., #820, Little Rock, AR 72205, USA
| | | | - Ginger Welch
- Department of Human Development and Family Science, Oklahoma State University, USA
| | - Larry L Mullins
- Department of Psychology, Oklahoma State University, USA
- Center for Pediatric Psychology, Oklahoma State University, USA
| | - John M Chaney
- Department of Psychology, Oklahoma State University, USA
- Center for Pediatric Psychology, Oklahoma State University, USA
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Bai L, Xu Y, Pan T, Zhang Y, Zhou X, Xu J. Leukotriene Receptor Antagonists and Risk of Neuropsychiatric Entities: A Meta-Analysis of Observational Studies. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:844-854.e9. [PMID: 36473625 DOI: 10.1016/j.jaip.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND Leukotriene receptor antagonists (LTRAs) are commonly prescribed to patients with allergic diseases. Several case reports and pharmacovigilance studies have indicated that LTRAs might increase the risk of neuropsychiatric (NP) entities. However, the results are mixed in observational studies. Thus, the association between LTRAs and NP entities remains controversial. OBJECTIVE To quantitatively evaluate the NP risk with LTRAs based on current observational studies to provide a reference for clinical practice. METHODS We systematically reviewed the literature in Medline, Embase, Web of Science, Cochrane Library, Scopus, and PsycINFO. A meta-analysis of observational studies that investigated the association between LTRA use and the risk of NP entities was performed. Odds ratios (OR) with 95% confidence intervals (CI) were used to measure the effect; heterogeneity was evaluated using I-squared (I2) statistics. Subgroup and sensitivity analyses were conducted to assess bias. RESULTS Eleven articles were included in the primary analysis. No significant association was found between LTRA use and NP entities (OR: 1.08, 95% CI: 0.93-1.24, I2 = 93.7%). In patients with allergic rhinitis (AR), a mildly increased NP risk was found (OR: 1.099, 95% CI: 1.004-1.202). The association between LTRA use and NP entities was not significant in patients with asthma (OR: 1.06, 95% CI: 0.90-1.26). LTRAs increased the risk of NP entities in a single study using data from an asthma clinic (OR: 9.00, 95% CI: 1.20-69.50), but not in studies from databases (OR: 1.07, 95% CI: 0.93-1.23). CONCLUSION At the population level, LTRAs and NP entities were unrelated. However, the association may exist in particular groups (eg, patients with AR or NP history). Subject-specific studies are required to further examine the relationship between LTRAs and NP entities and identify the underlying mechanisms.
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Affiliation(s)
- Le Bai
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yong Xu
- School of Chinese Medicine, School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Tingyu Pan
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Ying Zhang
- Department of Stomatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xianmei Zhou
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Department of Respiratory Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China.
| | - Jie Xu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Department of Respiratory Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
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10
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Effects of emotional contexts on respiratory attention task performance. Respir Physiol Neurobiol 2023; 308:103984. [PMID: 36368617 DOI: 10.1016/j.resp.2022.103984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/28/2022] [Accepted: 11/06/2022] [Indexed: 11/09/2022]
Abstract
Negative emotions have been found associated with high prevalence of respiratory disease and increased subjective feelings of dyspnea, while positive emotional stimulus has been suggested to alleviate dyspneic feelings. However, the extent to which different emotional contexts affect individuals' respiratory interoceptive attention was not clear. Therefore, the purpose of this study was to investigate the influences of emotional contexts on respiratory interoceptive accuracy, and the relationships between respiratory interoceptive accuracy and negative emotions as well as respiratory symptoms. Fifty-six healthy participants completed the self-reported questionnaires of depression, anxiety, and respiratory symptoms. During the experiment, the participants were instructed to watch one neutral and one positive affective picture series and mentally count the number of perceived occlusions (reported at the end of the trials). The Wilcoxon Signed-Rank test and Spearman's correlations were used to examine the effect of the emotional pictures and to explore the relationships between the level of emotional status or respiratory symptoms and respiratory interoceptive task performance. The significance level was set at p < 0.05. Our results did not show a significant difference in participants' occlusion counting task performance between the neutral and positive emotional context. However, Spearman's Rho correlation analysis revealed that depression level was negatively correlated with accuracy of the task performance in the neutral emotional context, and this relationship diminished in the positive emotional context. In summary, our study demonstrated that negative emotional status, especially depression, may lead to decreased respiratory interoceptive accuracy. Future studies are recommended to test the effect of positive emotional context on respiratory interoceptive task performance in individuals with clinical depression and anxiety.
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11
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Plank PM, Hinze CA, Campbell V, Konwert S, Welte T, Drick N, Kayser MZ, Suhling H, Fuge J. Relationship Between the Response to Antibody Therapy and Symptoms of Depression and Anxiety Disorders in Patients with Severe Asthma. J Asthma Allergy 2023; 16:421-431. [PMID: 37096014 PMCID: PMC10122462 DOI: 10.2147/jaa.s403296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 03/27/2023] [Indexed: 04/26/2023] Open
Abstract
Purpose Asthma is associated with a high prevalence of psychopathological disorders, especially depressive disorders or anxiety. In patients with uncontrolled severe asthma, monoclonal antibody (mAb)-therapy positively influenced control of mental disorders. Therefore, we evaluated the impact of antibody therapy on the burden of these mental diseases depending on responder status. Patients and Methods Data were collected retrospectively in patients with uncontrolled severe asthma (n = 82) prior to mAb-therapy ("baseline") (omalizumab, dupilumab, benralizumab or mepolizumab). Symptoms of Major Depressive Disorder (MDD) or General Anxiety Disorder (GAD) were detected at baseline using the Hospital Anxiety and Depression Scale (HADS), as well as general sociodemographic data and lung function parameters. At 6-month (±3 month) follow-up, the burden of psychopathological symptoms under mAb-therapy was assessed using the Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder Scale-2 (GAD-2). Response status was classified using the Biologics Asthma Response Score (BARS), assessing exacerbations, oral corticosteroid usage and asthma control test (ACT) score. Predictors for non-response to mAb-therapy were identified using linear regression analysis. Results Patients with severe asthma suffered from symptoms of MDD/GAD more often compared to the general population, with a higher prevalence among mAb therapy non-responders. mAb-responders exhibited a declining burden of MDD, better quality of life (QoL), less exacerbations, better lung function and better disease control compared to non-responders. A history of symptoms of depression was identified as a predictor for non-response to mAb-therapy. Conclusion Asthma symptoms and psychological problems are linked and more prevalent in our cohort of severe asthma patients than in the general population. Patients with signs of MDD/GAD before mAb-therapy show less mAb therapy response suggesting a negative impact of prior psychological problems on treatment response. In some patients, the score on MDD/GAD was caused by severe asthma - here symptoms decreased after effective treatment.
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Affiliation(s)
- Pia Maria Plank
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Christopher Alexander Hinze
- Department of Respiratory Medicine and Infectious Disease, Hannover Medical School, Hannover, Germany
- Correspondence: Christopher Alexander Hinze, Department of Respiratory Medicine and Infectious Disease, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover, 30625, Germany, Tel +49 511-5323531, Email
| | - Victoria Campbell
- Department of Paediatric Pulmonology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
| | - Stefanie Konwert
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Tobias Welte
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Nora Drick
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Moritz Z Kayser
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Hendrik Suhling
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Jan Fuge
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
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12
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Brown ES, Palka JM, Lehman HK, Kulikova A, Khan DA, Lopez J, Antony A, Persaud D, Tiro J, Ivleva EI, Nakamura A, Patel Z, Holmes T, Humayun Q, Lloyd T, Allen K, Kaur S, Owitz MS, Pak RJ, Zablonski KG, Adragna MS, Chankalal R, Wood BL, Miller BD. The Impact of Caregiver Depression on Child Asthma Outcomes: Pathways and Mechanisms. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:200-209. [PMID: 36610757 DOI: 10.1016/j.jaip.2022.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/02/2022] [Accepted: 09/14/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Depression is common in caregivers of children with asthma and is associated with poor outcomes in their child. No prior studies have longitudinally examined caregiver depression remission as a predictor of improvement in child asthma control. OBJECTIVE This 2-site study examined whether the proportion of time a caregiver was in depression remission predicted subsequent child asthma control at exit. METHOD Caregivers (n = 205) with current major depressive disorder and their children, ages 7 to 17, with persistent asthma were observed every 4 weeks for 52 weeks. Caregiver depressive symptoms were measured using the 17-item Hamilton Rating Scale for Depression (HRSD). Child asthma was assessed with the (Childhood) Asthma Control Test (cACT/ACT) and spirometry, and depression with the Children's Depression Inventory (CDI). Linear regression analyses were conducted with change in cACT/ACT, CDI, and forced expiratory volume in 1 second (FEV1)% predicted as outcomes and proportion of time the caregiver was in remission (HRSD score ≤ 7) as the predictor. Multilevel mediation analyses examined the role of child depressive symptoms and asthma controller medication adherence. RESULTS Children were, on average, 54.1% female and 11 years old. Caregiver proportion of time in HRSD-assessed remission of depression was a significant predictor of improvement in cACT/ACT, CDI, and FEV1% predicted. Child CDI score, but not medication adherence, mediated the relationship between caregiver HRSD scores and child asthma control scores. CONCLUSIONS Improvement in caregiver depression positively influences child asthma outcomes partially through improvement in child depressive symptom severity. Caregiver depression screening and treatment might lead to improvement in child asthma outcomes.
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Affiliation(s)
- E Sherwood Brown
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas.
| | - Jayme M Palka
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Heather K Lehman
- Department of Allergy and Immunology, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Alexandra Kulikova
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - David A Khan
- Division of Allergy & Immunology, Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Josseline Lopez
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Anna Antony
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Jasmine Tiro
- Department of Clinical Sciences, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Elena I Ivleva
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Alyson Nakamura
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Zena Patel
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Traci Holmes
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Quratulain Humayun
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Tressa Lloyd
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Karen Allen
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Savitoj Kaur
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - M Seth Owitz
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Ray J Pak
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Kevin G Zablonski
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Michael S Adragna
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Raymond Chankalal
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Beatrice L Wood
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Bruce D Miller
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
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13
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Mao EZ, Zhao L. The influence of job search stress on college students' addictive social media use: Seeking of social support and perceived social support as serial mediators and sense of coherence as a moderator. Front Psychol 2023; 14:1101674. [PMID: 36910808 PMCID: PMC9992423 DOI: 10.3389/fpsyg.2023.1101674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Resulting from an enlarged number of graduating college students and shrinkage of work opportunities, stress in relation to job search and employment is becoming an increasingly noticeable issue in China. Previous psychiatry research has suggested that social support can be conducive to reducing stress from multiple sources, while the effectiveness hinges on whether it is actually recognized and perceived by the recipients. The prevalence of social media has greatly facilitated the communication and exchange of social support information. However, they can also lead to overuse and addiction problems. This study aims to investigate how job search stress affects graduating college students' social media addiction severity using a serial mediation model and test the potential moderation effect of sense of coherence. Based on a sample of graduating college students (n = 144), our findings point out a significant pathway for the impacts of stress sequentially through seeking of social support and perceived social support. Furthermore, job search stress seems to have pronounced effects on the psychological need for social support only at low- and mid-levels of sense of coherence.
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Affiliation(s)
- Eric Zeqing Mao
- School of Cultural Creativity and Management, Communication University of Zhejiang, Hangzhou, China
| | - Lishou Zhao
- School of Cultural Creativity and Management, Communication University of Zhejiang, Hangzhou, China
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14
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Association between Asthma and Suicidality in 9-12-Year-Old Youths. Brain Sci 2022; 12:brainsci12121602. [PMID: 36552062 PMCID: PMC9775696 DOI: 10.3390/brainsci12121602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Suicidal ideation and attempts in youth are a growing health concern, and more data are needed regarding their biological underpinnings. Asthma is a common chronic inflammatory disorder in youth and has been associated with suicidal ideation and attempts in adolescent and adult populations, but data in younger children and early adolescents are lacking. We wished to study associations of asthma with childhood suicidality considering asthma's potential as a clinically relevant model for childhood chronic immune dysregulation. METHODS Using data from the Adolescent Brain Cognitive Development (ABCD) Study (n = 11,876, 47.8% female, mean age 9.9 years at baseline assessment and 12.0 years at two-year follow-up), we assessed associations between asthma and suicidal ideation and attempts through baseline to two-year follow-up. RESULTS Asthma history as defined by parent report (n = 2282, 19.2% of study population) was associated with suicide attempts (SA) (odds ratio (OR) = 1.44, p = 0.01), and this association remained significant even when controlling for demographics, socioeconomic factors, and environmental factors (OR = 1.46, p = 0.028). History of asthma attacks was associated with both suicidal ideation (SI) and SA when controlling for demographics, socioeconomic factors, and environmental factors (OR = 1.27, p = 0.042; OR = 1.83, p = 0.004, respectively). The association of asthma attack with SA remained significant when controlling for self-reported psychopathology (OR = 1.92, p = 0.004). The total number of asthma attacks was associated with both SI and SA (OR = 1.03, p = 0.043; OR = 1.06, p = 0.05, respectively). CONCLUSIONS Findings suggest an association between asthma and suicidality in early adolescence. Further research is needed to investigate mechanisms underlying this relationship.
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15
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Haas-Neil S, Dvorkin-Gheva A, Forsythe P. Severe, but not moderate asthmatics share blood transcriptomic changes with post-traumatic stress disorder and depression. PLoS One 2022; 17:e0275864. [PMID: 36206293 PMCID: PMC9543640 DOI: 10.1371/journal.pone.0275864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/23/2022] [Indexed: 11/24/2022] Open
Abstract
Asthma, an inflammatory disorder of the airways, is one of the most common chronic illnesses worldwide and is associated with significant morbidity. There is growing recognition of an association between asthma and mood disorders including post-traumatic stress disorder (PTSD) and major depressive disorder (MDD). Although there are several hypotheses regarding the relationship between asthma and mental health, there is little understanding of underlying mechanisms and causality. In the current study we utilized publicly available datasets of human blood mRNA collected from patients with severe and moderate asthma, MDD, and PTSD. We performed differential expression (DE) analysis and Gene Set Enrichment Analysis (GSEA) on diseased subjects against the healthy subjects from their respective datasets, compared the results between diseases, and validated DE genes and gene sets with 4 more independent datasets. Our analysis revealed that commonalities in blood transcriptomic changes were only found between the severe form of asthma and mood disorders. Gene expression commonly regulated in PTSD and severe asthma, included ORMDL3 a gene known to be associated with asthma risk and STX8, which is involved in TrkA signaling. We also identified several pathways commonly regulated to both MDD and severe asthma. This study reveals gene and pathway regulation that potentially drives the comorbidity between severe asthma, PTSD, and MDD and may serve as foci for future research aimed at gaining a better understanding of both the relationship between asthma and PTSD, and the pathophysiology of the individual disorders.
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Affiliation(s)
- Sandor Haas-Neil
- The Brain Body Institute, St. Joseph’s Hospital, McMaster University, Hamilton, Ontario, Canada
| | - Anna Dvorkin-Gheva
- McMaster Immunology Research Centre, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Paul Forsythe
- Alberta Respiratory Centre, Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- * E-mail:
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16
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Biologicals decrease psychological distress, anxiety and depression in severe asthma, despite Covid-19 pandemic. Respir Med 2022; 200:106916. [PMID: 35809428 PMCID: PMC9235286 DOI: 10.1016/j.rmed.2022.106916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 11/21/2022]
Abstract
Patients with respiratory diseases suffer more from problems of severe psychiatric comorbidity than the general population. Asthma might cause psychiatric disorders and affect patients' quality of life negatively. Previous studies reported that mental disorders prevail in asthmatic patients, causing anxiety, depression, and suicidal risk. The aim of this study is to evaluate in real life the prevalence of psychological comorbidities in asthmatics with severe asthma treated by biologicals (Benralizumab, Mepolizumab, Omalizumab). This study starts with the hypothesis that psychological distress, anxiety, depression and suicidal risk in severe asthma patients decreases if treated by biologicals. This study involves a sample of 90 patients (32 males, 58 females and aged 53.92 ± 15.92) suffering from severe asthma and treated with the biological drugs of Benralizumab, Mepolizumab, Omalizumab during Covid-19 pandemic. At the beginning of the treatment (T0) and after 16 weeks (T1), there have been reported results from both clinical disease control, assessed using the ACT, and psychological disorders, assessed with the PSS, HADS and C-SSRS. In the sample of these patients treated with biologicals for severe asthma, the study reported a significant change in all observed parameters, including asthma control (ACT), stress (PSS), anxiety (HADS-A) and depressive symptoms (HADS-D, despite Covid-19 pandemic. In addition, there was a significant improvement in disease management, perceived stress, anxiety and depressive symptoms after a 16 week treatment for severe asthma, independent from the type of biologic drugs used during the pandemic.
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17
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Fong WCG, Rafiq I, Harvey M, Stanescu S, Ainsworth B, Varkonyi-Sepp J, Mistry H, Kyyaly MA, Barber C, Freeman A, Wilkinson T, Djukanovic R, Dennison P, Haitchi HM, Kurukulaaratchy RJ. The Detrimental Clinical Associations of Anxiety and Depression with Difficult Asthma Outcomes. J Pers Med 2022; 12:jpm12050686. [PMID: 35629109 PMCID: PMC9142921 DOI: 10.3390/jpm12050686] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/27/2022] [Accepted: 04/06/2022] [Indexed: 01/04/2023] Open
Abstract
Difficult asthma describes asthma in which comorbidities, inadequate treatment, suboptimal inhaler technique and/or poor adherence impede good asthma control. The association of anxiety and depression with difficult asthma outcomes (exacerbations, hospital admissions, asthma control, etc.) is unclear. This study assessed the clinical associations of anxiety and depression with difficult asthma outcomes in patients with a specialist diagnosis of difficult asthma. Using real-world data, we retrospectively phenotyped patients from the Wessex Asthma Cohort of Difficult Asthma (N = 441) using clinical diagnoses of anxiety and depression against those without anxiety or depression (controls). Additionally, we stratified patients by severity of psychological distress using the Hospital Anxiety and Depression Scale (HADS). We found that depression and/or anxiety were reported in 43.1% of subjects and were associated with worse disease-related questionnaire scores. Each psychological comorbidity group showed differential associations with difficult asthma outcomes. Anxiety alone (7.9%) was associated with dysfunctional breathing and more hospitalisations [anxiety, median (IQR): 0 (2) vs. controls: 0 (0)], while depression alone (11.6%) was associated with obesity and obstructive sleep apnoea. The dual anxiety and depression group (23.6%) displayed multimorbidity, worse asthma outcomes, female predominance and earlier asthma onset. Worse HADS-A scores in patients with anxiety were associated with worse subjective outcomes (questionnaire scores), while worse HADS-D scores in patients with depression were associated with worse objective (ICU admissions and maintenance oral corticosteroid requirements) and subjective outcomes. In conclusion, anxiety and depression are common in difficult asthma but exert differential detrimental effects. Difficult asthma patients with dual anxiety and depression experience worse asthma outcomes alongside worse measures of psychological distress. There is a severity-gradient association of HADS scores with worse difficult asthma outcomes. Collectively, our findings highlight the need for holistic, multidisciplinary approaches that promote early identification and management of anxiety and depression in difficult asthma patients.
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Affiliation(s)
- Wei Chern Gavin Fong
- School of Clinical and Experimental Sciences, University of Southampton, Southampton SO16 6YD, UK; (W.C.G.F.); (J.V.-S.); (H.M.); (M.A.K.); (A.F.); (T.W.); (R.D.); (H.M.H.)
- David Hide Asthma and Allergy Research Centre, Isle of Wight NHS Trust, Isle of Wight PO30 5TG, UK
| | - Ishmail Rafiq
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK;
| | - Matthew Harvey
- NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (M.H.); (B.A.); (C.B.); (P.D.)
| | - Sabina Stanescu
- Department of Psychology, University of Southampton, Southampton SO17 1BJ, UK;
| | - Ben Ainsworth
- NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (M.H.); (B.A.); (C.B.); (P.D.)
- Department of Psychology, University of Bath, Bath BA2 7AY, UK
| | - Judit Varkonyi-Sepp
- School of Clinical and Experimental Sciences, University of Southampton, Southampton SO16 6YD, UK; (W.C.G.F.); (J.V.-S.); (H.M.); (M.A.K.); (A.F.); (T.W.); (R.D.); (H.M.H.)
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK;
- NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (M.H.); (B.A.); (C.B.); (P.D.)
| | - Heena Mistry
- School of Clinical and Experimental Sciences, University of Southampton, Southampton SO16 6YD, UK; (W.C.G.F.); (J.V.-S.); (H.M.); (M.A.K.); (A.F.); (T.W.); (R.D.); (H.M.H.)
- David Hide Asthma and Allergy Research Centre, Isle of Wight NHS Trust, Isle of Wight PO30 5TG, UK
- NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (M.H.); (B.A.); (C.B.); (P.D.)
| | - Mohammed Aref Kyyaly
- School of Clinical and Experimental Sciences, University of Southampton, Southampton SO16 6YD, UK; (W.C.G.F.); (J.V.-S.); (H.M.); (M.A.K.); (A.F.); (T.W.); (R.D.); (H.M.H.)
- David Hide Asthma and Allergy Research Centre, Isle of Wight NHS Trust, Isle of Wight PO30 5TG, UK
- NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (M.H.); (B.A.); (C.B.); (P.D.)
| | - Clair Barber
- NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (M.H.); (B.A.); (C.B.); (P.D.)
| | - Anna Freeman
- School of Clinical and Experimental Sciences, University of Southampton, Southampton SO16 6YD, UK; (W.C.G.F.); (J.V.-S.); (H.M.); (M.A.K.); (A.F.); (T.W.); (R.D.); (H.M.H.)
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK;
- NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (M.H.); (B.A.); (C.B.); (P.D.)
| | - Tom Wilkinson
- School of Clinical and Experimental Sciences, University of Southampton, Southampton SO16 6YD, UK; (W.C.G.F.); (J.V.-S.); (H.M.); (M.A.K.); (A.F.); (T.W.); (R.D.); (H.M.H.)
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK;
- NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (M.H.); (B.A.); (C.B.); (P.D.)
| | - Ratko Djukanovic
- School of Clinical and Experimental Sciences, University of Southampton, Southampton SO16 6YD, UK; (W.C.G.F.); (J.V.-S.); (H.M.); (M.A.K.); (A.F.); (T.W.); (R.D.); (H.M.H.)
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK;
- NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (M.H.); (B.A.); (C.B.); (P.D.)
| | - Paddy Dennison
- NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (M.H.); (B.A.); (C.B.); (P.D.)
- Department of Respiratory Medicine, University Hospitals Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Hans Michael Haitchi
- School of Clinical and Experimental Sciences, University of Southampton, Southampton SO16 6YD, UK; (W.C.G.F.); (J.V.-S.); (H.M.); (M.A.K.); (A.F.); (T.W.); (R.D.); (H.M.H.)
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK;
- NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (M.H.); (B.A.); (C.B.); (P.D.)
| | - Ramesh J. Kurukulaaratchy
- School of Clinical and Experimental Sciences, University of Southampton, Southampton SO16 6YD, UK; (W.C.G.F.); (J.V.-S.); (H.M.); (M.A.K.); (A.F.); (T.W.); (R.D.); (H.M.H.)
- David Hide Asthma and Allergy Research Centre, Isle of Wight NHS Trust, Isle of Wight PO30 5TG, UK
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK;
- NIHR Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; (M.H.); (B.A.); (C.B.); (P.D.)
- Correspondence:
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18
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[Asthma and suicidal behavior in adolescents: a literature review]. Rev Mal Respir 2022; 39:344-366. [PMID: 35459587 DOI: 10.1016/j.rmr.2021.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/21/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Adolescence is a difficult time in life and asthma has major psychological consequences for adolescents. OBJECTIVES This systematic literature review focused on the association between asthma and suicidal behaviors (suicidal ideations [SI], suicide plans [SP] and suicide attempts [SA]) among adolescents in the general population. METHOD Research on Medline for the 1980-2021 period. Objectives This systematic literature review focused on the association between asthma and suicidal behaviors (suicidal ideations [SI], suicide plans [SP] and suicide attempts [SA]) among adolescents in the general population. RESULTS An overwhelming majority of the studies taken into consideration demonstrated a significant positive association between asthma and suicidal behaviors. Among the 10 studies assessing SI (with or without SP), 9 of them found a significant positive association between asthma and SI. Eight studies assessed SA; five cross-sectional studies and one prospective study demonstrated a significant positive association between asthma and SA. Only one case-control study did not find a significant positive association between asthma and SA after hospitalization for asthma. The two cross-sectional studies assessing suicidal risk taken as a whole (SI, SP and SA) demonstrated a significant positive association between asthma and at least one suicidal behavior. (OR=1.71; P<0.001). However, several studies did not include depression as an adjustment factor. CONCLUSION It is important that healthcare professionals assess suicide risk in adolescent suffering from asthma, the objective being to avoid SA or death from SA.
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19
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Robinson PD, Jayasuriya G, Haggie S, Uluer AZ, Gaffin JM, Fleming L. Issues affecting young people with asthma through the transition period to adult care. Paediatr Respir Rev 2022; 41:30-39. [PMID: 34686436 DOI: 10.1016/j.prrv.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 11/15/2022]
Abstract
Asthma is among the most common medical conditions affecting children and young people, with adolescence a recognised period of increased risk, overrepresented in analyses examining recent increasing asthma mortality rates. Asthma may change significantly during this period and management also occurs in the context of patients seeking increased autonomy and self-governance whilst navigating increasing academic and social demands. A number of disease factors can destabilise asthma during adolescence including: increased rates of anaphylaxis, anxiety, depression, obesity, and, in females, an emerging resistance to corticosteroids and the pro-inflammatory effects of oestrogen. Patient factors such as smoking, vaping, poor symptom recognition, treatment non-adherence and variable engagement with health services contribute to difficult to treat asthma. Significant deficiencies in the current approach to transition have been identified by a recent EAACI task force, and subsequent asthma-specific recommendations, published in 2020 provide an important framework moving forward. As with other chronic conditions, effective transition programmes plan ahead, engage with adolescents and their families to identify the patients' management priorities and the current challenges they are experiencing with treatment. Transition needs may vary significantly across asthma patients and for more complex asthma may include dedicated transition clinics involving multidisciplinary care requiring input including, amongst others, allergy and immunology, psychological medicine, respiratory physicians and scientists and nurse specialists. Across different global regions, barriers to treatment may vary but need to be elicited and an individualised approach taken to optimising asthma care which is sustainable within the local adult healthcare system.
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Affiliation(s)
- Paul D Robinson
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, Australia; Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia.
| | - Geshani Jayasuriya
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, Australia; Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia; Dept of Adolescent Medicine, The Children's Hospital at Westmead, Sydney, Australia
| | - Stuart Haggie
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, Australia; Department of Paediatrics, Shoalhaven District Memorial Hospital, Nowra, Australia
| | - Ahmet Z Uluer
- Division of Pulmonary Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jonathan M Gaffin
- Division of Pulmonary Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Louise Fleming
- National Heart and Lung Institute, Imperial College, London UK; Respiratory Paediatrics, Royal Brompton Hospital, London, UK
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20
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Asthma Induces Psychiatric Impairments in Association With Default Mode and Salience Networks Alteration: A Resting-state EEG Study. Respir Physiol Neurobiol 2022; 300:103870. [DOI: 10.1016/j.resp.2022.103870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/19/2022] [Accepted: 02/11/2022] [Indexed: 11/23/2022]
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21
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Gaffin JM, Castro M, Bacharier LB, Fuhlbrigge AL. The Role of Comorbidities in Difficult-to-Control Asthma in Adults and Children. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:397-408. [PMID: 34863928 PMCID: PMC8837696 DOI: 10.1016/j.jaip.2021.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/29/2021] [Accepted: 11/22/2021] [Indexed: 02/07/2023]
Abstract
Assessment of asthma comorbidities, conditions that adversely affect the pathobiology of asthma or impair its response to therapies, is a fundamental step in the evaluation and management of patients with difficult-to-treat asthma. Identifying and effectively treating asthma comorbidities, such as obesity, obstructive sleep apnea, and chronic sinusitis with nasal polyps, may improve asthma control and reduce exacerbations. In addition, identifying comorbid T2 inflammatory conditions may help guide optimal selection of biologic therapies. Here, we describe common comorbid conditions found in adult and pediatric difficult-to-control asthma, discuss evidence for the association with asthma morbidity and treatment benefit, and provide information on how and when to assess comorbidities.
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Affiliation(s)
- Jonathan M. Gaffin
- Division of Pulmonary Medicine, Boston Children’s Hospital, 300 Longwood Avenue, Boston MA, USA
| | - Mario Castro
- Division of Pulmonary, Critical Care Medicine, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Leonard B. Bacharier
- Division of Pediatric Allergy, Immunology and Pulmonary Medicine, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN, USA
| | - Anne L. Fuhlbrigge
- Pulmonary Sciences and Critical Care, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
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22
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Rosenkranz MA, Esnault S, Gresham L, Davidson RJ, Christian BT, Jarjour NN, Busse WW. Role of amygdala in stress-induced upregulation of airway IL-1 signaling in asthma. Biol Psychol 2022; 167:108226. [PMID: 34800561 PMCID: PMC9426565 DOI: 10.1016/j.biopsycho.2021.108226] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/02/2021] [Accepted: 11/11/2021] [Indexed: 01/03/2023]
Abstract
Psychological stress, an important contributor to asthma morbidity, potentiates the immune response to allergen, but the brain mechanisms mediating this response are not fully understood. The amygdala is likely to play an important role, given its sensitivity to threat and connectivity with descending immune modulatory pathways. In this study, we recruited thirty asthmatic participants and examined glucose metabolism in the amygdala, using [F-18]fluorodeoxyglucose positron emission tomography, during a laboratory stressor. Stress hormone and airway inflammatory measurements were also acquired. Results showed that activity in the amygdala was significantly increased during the stressor, compared to a matched control task (p < .05 corrected). Moreover, the increase in amygdala activity was associated with a greater increase in sputum IL-1R1 mRNA and alpha amylase response (p < .05 corrected), which were also positively correlated (p = .01). These findings suggest that heightened amygdala reactivity may contribute to asthma morbidity via descending proinflammatory sympathetic signaling pathways.
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Affiliation(s)
- Melissa A Rosenkranz
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison, WI 53719, USA; Center for Healthy Minds, University of Wisconsin-Madison, 625 W. Washington Ave., Madison, WI 53703, USA.
| | - Stephane Esnault
- Department of Medicine, University of Wisconsin School of Medicine and Public Health-Madison, 600 Highland Ave, Madison, WI 53792, USA
| | - Lauren Gresham
- Center for Healthy Minds, University of Wisconsin-Madison, 625 W. Washington Ave., Madison, WI 53703, USA
| | - Richard J Davidson
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison, WI 53719, USA; Center for Healthy Minds, University of Wisconsin-Madison, 625 W. Washington Ave., Madison, WI 53703, USA; Department of Psychology, University of Wisconsin-Madison, 1202 W. Johnson St., Madison, WI 53706, USA
| | - Bradley T Christian
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison, WI 53719, USA; Department of Medical Physics, University of Wisconsin-Madison, 600 Highland Ave, Madison, WI 53792, USA; Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave, Madison, WI 53792, USA
| | - Nizar N Jarjour
- Department of Medicine, University of Wisconsin School of Medicine and Public Health-Madison, 600 Highland Ave, Madison, WI 53792, USA
| | - William W Busse
- Department of Medicine, University of Wisconsin School of Medicine and Public Health-Madison, 600 Highland Ave, Madison, WI 53792, USA
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23
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Mental health in patients with asthma: A population-based case-control study. Respir Med 2022; 193:106758. [DOI: 10.1016/j.rmed.2022.106758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/23/2021] [Accepted: 01/25/2022] [Indexed: 11/19/2022]
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24
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Park HJ, Kim YH, Na DY, Jeong SW, Lee MG, Lee JH, Yang YN, Kang MG, Yeom SW, Kim JS. Long-term bidirectional association between asthma and attention deficit hyperactivity disorder: A big data cohort study. Front Psychiatry 2022; 13:1044742. [PMID: 36741570 PMCID: PMC9893024 DOI: 10.3389/fpsyt.2022.1044742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/20/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Previous studies have argued that attention deficit hyperactivity disorder (ADHD) is associated with asthma. However, reliable evidence to verify this association has not yet been reported. OBJECTIVES To investigate the bidirectional association between asthma and ADHD through a 12-year big data cohort study. METHODS The independent variable group was extracted from 3.5 million individuals randomly sampled by the National Health Insurance Service (NHIS). In Study 1, the incidence of ADHD according to asthma was evaluated, while in Study 2, the incidence of asthma according to ADHD was analyzed. Propensity score (PS) matching with several variables was used to obtain a control group. MEASUREMENTS AND MAIN RESULTS In Study 1, the asthma group included 131,937 individuals and the non-asthma group included 131,937 individuals. The adjusted hazard ratio (aHR) for ADHD in the asthma group was 1.17 [95% confidence interval (CI): 1.11-1.23]. In subgroup analysis, the aHRs for ADHD of individuals in the subgroups male sex, 0-5 years old, 6-10 years old, atopic dermatitis, allergic rhinitis, Charlson comorbidity index (CCI) 1, and CCI > 2 were significant (aHR: 2.83, 1.70, 1.79, 1.09, 1.15, 1.06, and 1.49, respectively). In Study 2, ADHD was found to significantly affect asthma in all age groups (aHRs of the subgroups 0∼60 and 0∼17 years old were 1.10 and 1.09, respectively). In the 0∼17 years old subgroup, the association of ADHD with asthma was greater with younger age (aHRs of the subgroups 0∼5 and 6∼10 years old were 2.53 and 1.54, respectively). CONCLUSION From long-term follow-up, the incidence of ADHD was 1.17 times higher in the asthma group than in the control group. The incidence of asthma was 1.10 times higher in the ADHD group than in the control group. Asthma and ADHD have a bidirectional relationship, and childhood asthma and ADHD should be rigorously managed.
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Affiliation(s)
- Hye Jin Park
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Young Hyeon Kim
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Da Ye Na
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Seong Won Jeong
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Min Gyu Lee
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Jong-Hwan Lee
- Department of Otorhinolaryngology, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Yun Na Yang
- Department of Otorhinolaryngology, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Min Gu Kang
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Sang Woo Yeom
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Jong Seung Kim
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea.,Department of Otorhinolaryngology, Jeonbuk National University Medical School, Jeonju, Republic of Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
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25
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Turi ER, Reigada LC, Liu J, Leonard SI, Bruzzese JM. Associations among anxiety, self-efficacy, and self-care in rural adolescents with poorly controlled asthma. Ann Allergy Asthma Immunol 2021; 127:661-666.e1. [PMID: 34547441 PMCID: PMC8627490 DOI: 10.1016/j.anai.2021.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/17/2021] [Accepted: 09/11/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Rural adolescents are vulnerable to asthma; good self-care can reduce morbidity. The subtypes of anxiety (eg, asthma-related, generalized) may have differential associations with asthma self-care. Low self-efficacy, a determinant of behavior, is associated with increased anxiety. Little is known regarding these relationships in rural adolescents. OBJECTIVE To evaluate whether anxiety symptoms are associated with asthma symptom prevention and management among rural adolescents and whether self-efficacy mediates these relationships. METHODS We used baseline data from 197 rural adolescents (mean age = 16 years; 69% girls; 62% Black) who were part of a trial that tested the effectiveness of a school-based asthma intervention. Adolescents completed the Youth Asthma-Related Anxiety Scale, Screen for Child Anxiety and Emotional Disorders, Asthma Management Self-efficacy Index, and Asthma Prevention and Management Indices. Linear regression was performed to test whether: (1) asthma-related and generalized anxiety had curvilinear relationships with self-care; (2) social and separation anxiety had linear relationships with self-care; and (3) self-efficacy mediated relationships. RESULTS Asthma-related anxiety had a significant curvilinear relationship with prevention (P = 0.001) and a linear association with management (P = .01). Generalized anxiety had a significant curvilinear association with management (P = .03), whereas social anxiety had a significant linear relationship with prevention (P = .04). Self-efficacy partially or fully mediated these relationships. CONCLUSION Anxiety symptoms were associated with asthma self-care among this sample of rural adolescents, with differing roles for prevention and management. Self-efficacy may be a mechanism to improve asthma self-care among rural adolescents with anxiety. With a lack of self-efficacy, asthma-related, generalized, or social anxiety may motivate adolescents to take steps to care for their asthma.
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Affiliation(s)
- Eleanor R Turi
- Office of Scholarship and Research, Columbia University School of Nursing, New York, New York
| | - Laura C Reigada
- Department of Psychology, Brooklyn College and The Graduate Center, The City University of New York, New York, New York
| | - Jianfang Liu
- Office of Scholarship and Research, Columbia University School of Nursing, New York, New York
| | - Sarah I Leonard
- Office of Scholarship and Research, Columbia University School of Nursing, New York, New York
| | - Jean-Marie Bruzzese
- Office of Scholarship and Research, Columbia University School of Nursing, New York, New York.
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26
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Chong-Fah-Shen K, Bumbacea R, Bassani C, Beltran CFP, Pham D, Lefevre S, Brandatan E, Vasconcelos MJ, Baldaçara R, Monsell S, Djuric-Filipovic I, Darlenski R, Pouessel G, Gonzalez-Estrada A, Caminati M, Tanno LK. Physician's experience on managing asthma in adolescents: results of the International AMADO (Asthma Management in ADOlescents) survey. Asia Pac Allergy 2021; 11:e45. [PMID: 34786375 PMCID: PMC8563100 DOI: 10.5415/apallergy.2021.11.e45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022] Open
Abstract
Background Worldwide prevalence of asthma seems to be increasing in adolescents, but limited data is available regarding the management of asthma in this age group. Objective Therefore, we conducted an international survey focused on physicians who manage asthma in order to understand how Asthma Management in ADOlescents (AMADO) is currently performed. Methods The AMADO survey is a web-based global survey of physician's attitudes towards the management of asthma in adolescents, circulated for 17 weeks. The survey had an anonymous and voluntary standard. The questionnaire consisted in 27 questions covering the training background of respondents, difficulties in diagnosis, and in management of asthma in adolescents. Results Two hundred forty-four responses were received from 46 countries, from all continents. Most (65%) of participants indicated allergy as being their main specialty. The majority of participants (62%) had more than 5 years of clinical practice, but 62% have no formal training in management of adolescents with asthma. Most of participants (96%) indicated having at least one case of asthma in adolescents per month. 60% of respondents mentioned that the asthmatic adolescents only had the consultation due to the family imposition. All respondents mentioned having difficulties in the management of asthma in adolescents due to patient poor adherence. Overall, 44% of participants have no specific health care resources for adolescents in their departments. Main suggestions from the participants were: optimization of time and personalized communication to these cohort, and standardization of multidisciplinary actions to improve adherence to asthma control treatment. Conclusion Management of asthma in adolescents is still a challenge in clinical practice. The results from this survey helped us to identify the key issues to improve clinical outcomes in the future. This survey is the first step of the international AMADO initiative, which intends to optimize diagnosis and control of asthma and prevent avoidable deaths.
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Affiliation(s)
| | - Roxana Bumbacea
- University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
| | | | | | - Duy Pham
- Department of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Sebastien Lefevre
- Regional Institute for Allergic and Environmental Diseases - Clinical Immunology, Metz Regional Hospital, Metz, France
| | - Elena Brandatan
- Centre Hospitalier Regional, Department of Pediatrics Pneumology - Allergology, Namur, Belgium
| | - Maria João Vasconcelos
- Allergy and Clinical Immunology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | | | | | | | - Razvigor Darlenski
- Department of Dermatolgy and Venereology, Tokuda Hospital Sofia, Sofia, Bulgaria
| | - Guillaume Pouessel
- Pediatric Pulmonology and Allergy Department, Pôle enfant, Hôpital Jeanne de Flandre, CHRU de Lille and Université Nord de France, Lille, France
| | - Alexei Gonzalez-Estrada
- Divsion of Pulmonary, Allergy, and Sleep Medicine, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Marco Caminati
- Department of Medicine, University of Verona and Asthma Center and Allergy Unit, Verona University Hospital, Verona, Italy
| | - Luciana Kase Tanno
- University Hospital of Montpellier, Montpellier, France.,Desbrest Institute of Epidemiology and Public Health, Université de Montpellier, UMR UA11 INSERM, Montpellier, France
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27
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Caulfield JI. Anxiety, depression, and asthma: New perspectives and approaches for psychoneuroimmunology research. Brain Behav Immun Health 2021; 18:100360. [PMID: 34661176 PMCID: PMC8502834 DOI: 10.1016/j.bbih.2021.100360] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 09/22/2021] [Accepted: 09/25/2021] [Indexed: 12/30/2022] Open
Abstract
The field of psychoneuroimmunology has advanced the understanding of the relationship between immunology and mental health. More work can be done to advance the field by investigating the connection between internalizing disorders and persistent airway inflammation from asthma and air pollution exposure. Asthma is a prominent airway condition that affects about 10% of developing youth and 7.7% of adults in the United States. People who develop with asthma are at three times increased risk to develop internalizing disorders, namely anxiety and depression, compared to people who do not have asthma while developing. Interestingly, sex differences also exist in asthma prevalence and internalizing disorder development that differ based on age. Exposure to air pollution also is associated with increased asthma and internalizing disorder diagnoses. New perspectives of how chronic inflammation affects the brain could provide more understanding into internalizing disorder development. This review on how asthma and air pollution cause chronic airway inflammation details recent preclinical and clinical research that begins to highlight potential mechanisms that drive comorbidity with internalizing disorder symptoms. These findings provide a foundation for future studies to identify therapies that can simultaneously treat asthma and internalizing disorders, thus potentially decreasing mental health diagnoses in asthma patients.
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Affiliation(s)
- Jasmine I Caulfield
- Yale Cancer Center, Yale School of Medicine, 333Cedar Street, New Haven, CT, 06510, USA
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28
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Hawke LD, Monga S, Korczak D, Hayes E, Relihan J, Darnay K, Cleverley K, Lunsky Y, Szatmari P, Henderson J. Impacts of the COVID-19 pandemic on youth mental health among youth with physical health challenges. Early Interv Psychiatry 2021; 15:1146-1153. [PMID: 33047495 PMCID: PMC7675347 DOI: 10.1111/eip.13052] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/04/2020] [Accepted: 09/26/2020] [Indexed: 12/28/2022]
Abstract
AIM To examine mental health in conjunction with physical health during the COVID-19 pandemic among youth with physical health conditions compared to those without. METHODS A cross-sectional survey of 622 youth aged 14 to 28 was conducted. Analyses were conducted to understand the changes in mental and physical health among youth in four groups: (a) participants with a friend or family member diagnosed with COVID-19, (b) participants with symptoms associated with COVID-19, (c) participants with atopic conditions (asthma and allergies), and (d) participants with other preexisting physical health conditions. RESULTS Many participants with physical health concerns met screening criteria for an internalizing disorder, which was significantly higher than the rate found among participants without physical health conditions. Significantly greater declines in self-reported mental health were observed during the COVID-19 period compared to 3 months earlier among youth reporting physical health concerns compared to those without physical health concerns. Substance use does not appear to have been affected. CONCLUSIONS Mental health concerns are highly prevalent among youth with physical health concerns, and also appear to be exacerbated by the COVID-19 pandemic. Physical health concerns appear to constitute risk factors for heightened mental health responses to the pandemic situation. System planners striving to adapt mental health services to meet social/physical distancing recommendations are urged to consider youth with physical health conditions and ensure that adequate integrated mental health and physical health supports are available to them.
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Affiliation(s)
- Lisa D Hawke
- Centre for Addiction and Mental Health, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Suneeta Monga
- Hospital for Sick Children, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Daphne Korczak
- Hospital for Sick Children, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Em Hayes
- Centre for Addiction and Mental Health, Toronto, Canada
| | | | | | | | - Yona Lunsky
- Centre for Addiction and Mental Health, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Joanna Henderson
- Centre for Addiction and Mental Health, Toronto, Canada.,University of Toronto, Toronto, Canada
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29
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Rajhans P, Sagar R, Patra BN, Bhargava R, Kabra SK. Psychiatric Morbidity and Behavioral Problems in Children and Adolescents with Bronchial Asthma. Indian J Pediatr 2021; 88:968-973. [PMID: 33625668 DOI: 10.1007/s12098-021-03661-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Psychiatric morbidity and behavioral problems are quite common in children and adolescents with bronchial asthma, yet they remain underexplored and often ignored in clinical settings. This can impact the child's overall quality of life. There seems to be a dearth of Indian literature and so the current study was planned to assess psychological impact of asthma on the pediatric population. METHODS Thirty children and adolescents, attending the Pediatric Chest Clinic at a tertiary care hospital in North India in the age group of 8-15 y having moderate to severe asthma formed the study group and matched healthy controls formed the other group. Sociodemographic and clinical details were obtained. Mini International Neuropsychiatric Interview (M.I.N.I. KID) and Child Behavior Checklist (CBCL) were applied. RESULTS Irregular attendance at school was reported by 23.33% of the participants with asthma. About 17% of the thirty study-participants were diagnosed with specific phobia, 10% with conduct disorder, and 7% with attention deficit hyperactivity disorder (ADHD). Participants in the study group had significantly more behavioral problems in the syndrome domain anxious/depressed and attention problems. Total CBCL scores were significantly higher in the study group as compared to the control group (t = 3.816, p = 0.0003), indicating the presence of more behavioral problems in pediatric population with bronchial asthma. CONCLUSION Children and adolescents with bronchial asthma have co-morbid psychiatric morbidities and behavioral problems.
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Affiliation(s)
- Pallavi Rajhans
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
| | - Bichitra Nanda Patra
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Rachna Bhargava
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Sushil Kumar Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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30
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Harrison OK, Marlow L, Finnegan SL, Ainsworth B, Pattinson KTS. Dissociating breathlessness symptoms from mood in asthma. Biol Psychol 2021; 165:108193. [PMID: 34560173 PMCID: PMC9355895 DOI: 10.1016/j.biopsycho.2021.108193] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 09/09/2021] [Accepted: 09/16/2021] [Indexed: 12/21/2022]
Abstract
It is poorly understood why asthma symptoms are often discordant with objective medical tests. Differences in interoception (perception of internal bodily processes) may help explain symptom discordance, which may be further influenced by mood and attention. We explored inter-relationships between interoception, mood and attention in 63 individuals with asthma and 30 controls. Questionnaires, a breathing-related interoception task, two attention tasks, and standard clinical assessments were performed. Questionnaires were analysed using exploratory factor analysis, and linear regression examined relationships between measures. K-means clustering also defined asthma subgroups. Two concordant asthma subgroups (symptoms related appropriately to pathophysiology, normal mood) and one discordant subgroup (moderate symptoms, minor pathophysiology, low mood) were found. In all participants, negative mood correlated with decreased interoceptive ability and faster reaction times in an attention task. Our findings suggest that interpreting bodily sensations relates to mood, and this effect may be heightened in subgroups of individuals with asthma.
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Affiliation(s)
- Olivia K Harrison
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland; Department of Psychology, University of Otago, Dunedin, New Zealand; Wellcome Centre for Integrative Neuroimaging, and Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Lucy Marlow
- Wellcome Centre for Integrative Neuroimaging, and Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Sarah L Finnegan
- Wellcome Centre for Integrative Neuroimaging, and Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Ben Ainsworth
- Department of Psychology, University of Bath, United Kingdom
| | - Kyle T S Pattinson
- Wellcome Centre for Integrative Neuroimaging, and Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom.
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31
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Moore PS, Mokrova I, Frazier JA, Joseph RM, Santos HP, Dvir Y, Hooper SR, O'Shea TM, Douglass LM, Kuban KCK. Anxiety and Depression Correlates at Age 10 in Children Born Extremely Preterm. J Pediatr Psychol 2021; 46:422-432. [PMID: 33398339 DOI: 10.1093/jpepsy/jsaa118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 10/27/2020] [Accepted: 11/13/2020] [Indexed: 12/14/2022] Open
Abstract
Objective Anxiety and depression rates are known to be elevated in prematurely-born children and adolescents. This prospective study examines demographic, academic, and physical health correlates of anxiety and depression symptoms in a sample of 10-year-old children who were born extremely preterm. Methods Participants were 889 (51.2% male; 62.3% White) children who were born <28 weeks gestation. Child and family demographic data were collected at birth. When the children were 10, parents (n = 871) and teachers (n = 640) rated the level of anxiety and depression in children through the Child Symptom Inventory-4. Child academic functioning was assessed via the Wechsler Individual Achievement Test-III. Parents completed questionnaires about child academic functioning and physical health issues. Data analyses were conducted with multivariate linear modeling. Results Level of prematurity was significantly related to both parent and teacher reports of anxiety. Public health insurance and individualized education program (IEP) status were associated with both parent and teacher reports of depression. Hispanic ethnicity, public insurance, IEP status, and asthma were significantly associated with both parent-reported anxiety and depression. Gross motor impairment was associated with parent-reported anxiety and teacher-reported depression. Child obesity was associated with teacher reports of anxiety, while male sex was significantly related to teacher reports of depression. Conclusion This pattern of findings may suggest hypotheses for future research on models of the development and persistence of anxiety and depression within this particularly vulnerable group of children.
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Affiliation(s)
- Phoebe S Moore
- Department of Psychiatry and the Eunice Kennedy Shriver Center, University of Massachusetts Medical School
| | | | - Jean A Frazier
- Department of Psychiatry and the Eunice Kennedy Shriver Center, University of Massachusetts Medical School
| | | | | | - Yael Dvir
- Department of Psychiatry and the Eunice Kennedy Shriver Center, University of Massachusetts Medical School
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Multivariate Association of Child Depression and Anxiety with Asthma Outcomes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:2399-2405. [PMID: 33677079 DOI: 10.1016/j.jaip.2021.02.043] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/25/2021] [Accepted: 02/18/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Pediatric asthma is associated with increased health services utilization, missed school days, and diminished quality of life. Children with asthma also report more frequent depressive and anxiety symptoms than children without asthma, which may further worsen asthma outcomes. OBJECTIVE The current study investigated the relationship between depressive and anxiety symptoms and 4 asthma outcomes (asthma control, asthma severity, lung function, and asthma-related quality of life) in children (N = 205) with moderate to severe persistent asthma. METHODS The data were analyzed using a canonical correlation analysis, a multivariate framework that allows examination of all variables of interest in the same model. RESULTS We found a statistically significant relationship between symptoms of depression and anxiety and asthma outcomes (1 - Λ = .372; P < .001). A large effect size suggests that 37.2% of variance is shared between depression and anxiety symptoms and 4 asthma outcomes (particularly asthma control and asthma-related quality of life) in the overall sample. Among girls (vs. boys), asthma control (measured by the Asthma Control Test) emerged as a stronger contributor to asthma outcomes compared with boys. CONCLUSIONS These results suggest that psychiatric symptoms, especially anxiety, are associated with poor asthma-related quality of life, and more negative perception of asthma control in girls compared with boys (with no observed sex difference in physiological lung function). Clinicians should consider incorporating questions about psychiatric symptoms as part of routine asthma management, and focus patient education on unique differences in which boys and girls perceive their asthma symptoms.
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Le TP, Sutherlin TK, Teverbaugh LA, Gleason MM, Carlson JC. The impact of socioeconomic risk factors and mental health on asthma. Ann Allergy Asthma Immunol 2021; 126:453-457. [PMID: 33610758 DOI: 10.1016/j.anai.2021.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/24/2021] [Accepted: 02/12/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Thao P Le
- Department of Pediatrics, Tulane University, New Orleans, Louisiana
| | | | | | - Mary Margaret Gleason
- Eastern Virginia Medial School, Norfolk, Virginia; Childnren's Hospital of the King's Daughters, Chesapeake, Virginia
| | - John C Carlson
- Department of Pediatrics, Tulane University, New Orleans, Louisiana.
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Griffiths D, Giancola LM, Welsh K, MacGlashing K, Thayer C, Gunnlaugsson S, Stamatiadis NP, Sierra GC, Hammond A, Greco KF, Simoneau T, Baxi SN, Gaffin JM. Asthma control and psychological health in pediatric severe asthma. Pediatr Pulmonol 2021; 56:42-48. [PMID: 33058494 PMCID: PMC7736198 DOI: 10.1002/ppul.25120] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Psychological comorbidities have been associated with asthma in adults and children, but have not been studied in a population of children with severe asthma. The aim of this study was to test the hypothesis that symptoms of anxiety or depression are highly prevalent in pediatric severe asthma and negatively effects asthma control. METHODS Longitudinal assessments of anxiety or depression symptoms (Patient Health Questionnaire-4 [PHQ-4]), asthma control (Asthma Control Test [ACT]), and lung function were performed in a single-center pediatric severe asthma clinic. Participant data were collected during routine clinical care. Primary outcomes were ACT and forced expiratory volume in 1 s per forced vital capacity (FEV1/FVC). RESULTS Among 43 subjects (with total 93 observations), 58.1% reported at least one anxious or depressive symptom and 18.6% had a PHQ-4 more than 2, the threshold for an abnormal test result. After adjusting for age, sex, race, and asthma medication step, there was a significant reduction in ACT for girls with PHQ-4 more than 2 (adjusted mean [SE] ACT for PHQ-4 > 2: 13.64 [0.59], ACT for PHQ-4 ≤ 2: 20.64 [1.25], p = .02) but not boys. Moreover, there was a significant differential effect of mental health impairment for girls than boys. ACT for girls with PHQ more than 2: 13.64 (0.59) compared with boys with PHQ-4 more than 2: 17.82 (0.95), adjusted mean difference ACT by sex = 4.18 points; 95% confidence interval, 0.63-7.73; p = .033. In adjusted models, there was no association between PHQ-4 more than 2 and FEV1/FVC. CONCLUSIONS Symptoms of anxiety and depression are common. In children with severe asthma, a PHQ-4 score more than 2 is associated with worse asthma symptom control in girls, but not boys.
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Affiliation(s)
- Delaney Griffiths
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Lauren M Giancola
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Kelly Welsh
- Department of Social Work, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Kristen MacGlashing
- Department of Social Work, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Christine Thayer
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Sigfus Gunnlaugsson
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Natalie P Stamatiadis
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Gabriella C Sierra
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Adam Hammond
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Kimberly F Greco
- Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Tregony Simoneau
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Sachin N Baxi
- Harvard Medical School, Boston, Massachusetts, USA.,Division of Allergy and Immunology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Jonathan M Gaffin
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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Inhaled corticosteroids as treatment for adolescent asthma: effects on adult anxiety-related outcomes in a murine model. Psychopharmacology (Berl) 2021; 238:165-179. [PMID: 33011818 PMCID: PMC8787845 DOI: 10.1007/s00213-020-05666-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 09/14/2020] [Indexed: 02/02/2023]
Abstract
RATIONALE Allergic asthma, typically controlled with inhaled corticosteroids (ICS), is the leading chronic health condition for youth under 18 years of age. During this peri-adolescent period, significant brain maturation occurs. Prior studies indicate that both chronic inflammation and corticosteroid medications increase risk for developing an internalizing disorder like anxiety. OBJECTIVES To determine if chronic ICS treatments exacerbate or alleviate anxiety symptoms associated with developmental allergic asthma, we used a mouse model to isolate the influence of ICS (fluticasone propionate, FLU) vs. airway inflammation (induced with house dust mite extract, HDM). METHODS During development, male and female BALB/cJ mice were repeatedly exposed to HDM or saline plus one of four FLU doses (none/vehicle, low, moderate, or high). In adulthood, we assessed lung inflammation, circulating and excreted corticosteroids, anxiety-like behavior, and gene expression in stress and emotion regulation brain regions. RESULTS FLU treatment decreased body weight and anxiety-like behavior and increased fecal corticosterone metabolite concentrations and Crhr2 gene expression in ventral hippocampus. FLU effects were only observed in saline/non-HDM-exposed mice, and the FLU doses used did not significantly decrease HDM-induced airway inflammation. Females had greater serum and fecal corticosterone concentrations, less anxiety-like behavior, and lower Crhr1 gene expression in ventral hippocampus and prefrontal cortex than males. CONCLUSIONS These findings suggest that steroid medications for youth with allergic asthma may not exacerbate anxiety-related symptoms, and that they should be avoided in children/adolescents without a health condition. The results are informative to future work on the use of corticosteroid medications during childhood or adolescent development.
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Caulfield JI, Schopf KJ, Cavigelli SA. Peri-adolescent asthma: Acute impacts on innate immune response, corticosterone, and microglia in mice. J Neuroimmunol 2020; 350:577450. [PMID: 33285450 PMCID: PMC7750285 DOI: 10.1016/j.jneuroim.2020.577450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/27/2020] [Accepted: 11/12/2020] [Indexed: 12/28/2022]
Abstract
Asthma is highly comorbid with anxiety in youth. We investigated the hypothalamic-pituitary-adrenal (HPA) axis and microglia as mechanisms underlying asthma and anxiety comorbidity. We induced asthma symptoms in developing BALB/cJ mice with house dust mite (HDM) for airway inflammation and methacholine (MCH) for bronchoconstriction. On the last day of exposure, we analyzed samples at six timepoints. Lung IL-5 and IL-1β expression peaked 4 h after final HDM exposure. Circulating corticosterone was blunted in a sex- and treatment-specific temporal pattern. Hippocampal IL-1β expression and microglial area were marginally increased 24 h after MCH exposure. These results provide a foundation for further work investigating asthma-anxiety mechanisms.
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Affiliation(s)
- Jasmine I Caulfield
- Pennsylvania State University, Huck Institute for Life Sciences, 101 Life Sciences Building, University Park, PA 16802, USA; Pennsylvania State University, Department of Biobehavioral Health, 219 Biobehavioral Health Building, University Park, PA 16802, USA; Pennsylvania State University, Center for Brain, Behavior, Cognition, University Park, PA 16802, USA.
| | - Kerri J Schopf
- Pennsylvania State University, Department of Biobehavioral Health, 219 Biobehavioral Health Building, University Park, PA 16802, USA
| | - Sonia A Cavigelli
- Pennsylvania State University, Huck Institute for Life Sciences, 101 Life Sciences Building, University Park, PA 16802, USA; Pennsylvania State University, Department of Biobehavioral Health, 219 Biobehavioral Health Building, University Park, PA 16802, USA; Pennsylvania State University, Center for Brain, Behavior, Cognition, University Park, PA 16802, USA
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Tel BC, Telli G, Onder S, Nemutlu E, Bozkurt TE. Investigation of the relationship between chronic montelukast treatment, asthma and depression-like behavior in mice. Exp Ther Med 2020; 21:27. [PMID: 33262813 PMCID: PMC7690246 DOI: 10.3892/etm.2020.9459] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 06/26/2020] [Indexed: 12/13/2022] Open
Abstract
In 2008, the Food and Drug Administration of the US issued a warning about the neuropsychiatric side effects of montelukast. Previous clinical studies on montelukast have reported conflicting results and, to the best of our knowledge, no experimental studies concerning these side effects had been conducted. In the current study, the effect of montelukast on depression-like behavior in an ovalbumin (OVA)-induced mouse model was investigated. A total of 3 OVA challenges were applied at 2 week intervals for the persistence of asthma. Depression-like behavior was assessed using forced swim tests following each challenge and locomotor activities were evaluated using open field tests. At the end of the current study, plasma montelukast concentrations were measured and the development of asthma and effect of montelukast treatment were histopathologically examined. Inflammation scores that were increased in the OVA mice following all challenges were indicated to be reduced by montelukast treatment. The immobility time of mice increased beginning with the first challenge and this was also reduced by montelukast treatment. Montelukast administration to the control mice did not alter immobility times. Moreover, motor activity of the OVA and montelukast-treated mice were not altered. The results indicated there was no association between chronic montelukast treatment and depression. Furthermore, the chronic administration of montelukast to non-asthmatic mice did not increase immobility. However, depressive behavior increased at all time points in the OVA mice. These results indicated that chronic montelukast treatment is not associated with depression-like behavior and confirmed the association between asthma and depression. Further studies are required to provide an improved understanding of the neuropsychiatric side effects of montelukast.
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Affiliation(s)
- Banu Cahide Tel
- Department of Pharmacology, Hacettepe University Faculty of Pharmacy, Ankara, Sihhiye 06100, Turkey
| | - Gokcen Telli
- Department of Pharmacology, Hacettepe University Faculty of Pharmacy, Ankara, Sihhiye 06100, Turkey
| | - Sevgen Onder
- Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Sihhiye 06100, Turkey
| | - Emirhan Nemutlu
- Department of Analytical Chemistry, Hacettepe University Faculty of Pharmacy, Ankara, Sihhiye 06100, Turkey
| | - Turgut Emrah Bozkurt
- Department of Pharmacology, Hacettepe University Faculty of Pharmacy, Ankara, Sihhiye 06100, Turkey
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Munoz FA, Benton LD, Kops SA, Kowalek KA, Seckeler MD. Greater length of stay and hospital charges for severe asthma in children with depression or anxiety. Pediatr Pulmonol 2020; 55:2908-2912. [PMID: 32902930 DOI: 10.1002/ppul.25061] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/23/2020] [Accepted: 09/03/2020] [Indexed: 11/11/2022]
Abstract
RATIONALE Asthma is one of the most common chronic disorders of childhood and is associated with significant healthcare utilization and costs. Comorbid psychiatric illnesses, specifically depression and anxiety, are more prevalent in patients with asthma and associated with worse asthma control, more emergency department visits, and increased hospitalization rates. OBJECTIVES We aimed to compare hospital outcomes and charges for children with severe asthma with and without comorbid depression and anxiety, hypothesizing that those with depression and anxiety would have longer hospitalizations and higher charges. METHODS Retrospective review of the 2000-2012 Healthcare Cost and Utilization Project's Kids' Inpatient Databases for admissions of patients aged 10-21 years with an ICD-9 code severe asthma (status asthmaticus or any asthma diagnosis with a procedure code for endotracheal intubation). Depression and Anxiety subgroups were created based on ICD-9 codes. Data collected included demographics, hospital outcomes and charges and comparisons made between groups. RESULTS There were 52,485 admissions for severe asthma: 45,094 (86%) with No Comorbid Psychiatric Illnesses, 1284 (2.4%) with depression, and 1297 (2.5%) with anxiety. Patients with depression or anxiety were older, had longer hospitalizations, and higher hospital charges (p < .001 for all). CONCLUSIONS Comorbid depression or anxiety is associated with significantly longer hospitalizations and higher charges for children with severe asthma. These findings add to prior reports of worse outcomes for children with asthma and comorbid depression or anxiety and suggest that improved screening for and management of these conditions in children with asthma could improve hospital outcomes and reduce costs.
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Affiliation(s)
- Fernando A Munoz
- Department of Pediatrics, University of Arizona, Tucson, Arizona, USA
| | - Lauren D Benton
- Department of Pediatrics (Pulmonology), University of Arizona, Tucson, Arizona, USA
| | - Samantha A Kops
- Department of Pediatrics, University of Arizona, Tucson, Arizona, USA
| | - Katie A Kowalek
- Department of Pediatrics (Critical Care), University of Arizona, Tucson, Arizona, USA
| | - Michael D Seckeler
- Department of Pediatrics (Cardiology), University of Arizona, Tucson, Arizona, USA
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Kimura M, Ikeda A, Suzuki Y, Maruyama K, Wada H, Tanigawa T. The association between asthma and anxiety in elementary school students in Japan. Pediatr Pulmonol 2020; 55:2603-2609. [PMID: 32720730 DOI: 10.1002/ppul.24986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/06/2020] [Accepted: 07/26/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Studies on the association between asthma and anxiety in Asian children are limited. Therefore, we aimed to evaluate the association between asthma and anxiety among Japanese elementary school students. METHODS A cross-sectional study of the association between asthma and anxiety in primary school children in Matsuyama City was conducted in 2014. The questionnaires included inquiries on asthma, anxiety, and other demographic variables. After excluding missing values, 17 752 (51.5% male) children were included in the analysis. The presence of asthma (yes/no) was answered by guardians. A score of four or more on the emotional symptom subscale of the strengths and difficulties questionnaire was considered as having anxiety. A Rohrer index score of 145 or more was considered as overweight. We estimated the prevalence ratio (PR) of having anxiety in relation to the presence of asthma based on the Poisson regression model. RESULTS The multivariate PR (95% confidence interval) of having anxiety in asthmatic boys compared with non-asthmatic boys was 1.56 (1.21-1.99). The association was more evident in older than younger boys, where PR = 1.32 (0.93-1.88) for younger versus 1.87(1.32-2.64) for older boys (P for interaction = .08); and in non-overweight boys than overweight, where PR = 1.64 (1.27-2.13) and 0.94 (0.41-2.19) (P for interaction = .22), respectively. Similar associations were not found for girls. CONCLUSION Asthma was significantly associated with anxiety in boys, particularly in older boys.
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Affiliation(s)
- Manami Kimura
- Department of Public Health, Graduate School of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - Ai Ikeda
- Department of Public Health, Graduate School of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - Yohei Suzuki
- Department of Public Health, Graduate School of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - Koutatsu Maruyama
- Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Ehime, Japan
| | - Hiroo Wada
- Department of Public Health, Graduate School of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Graduate School of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan
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Schend J, Rowane M, Sanan N, Hostoffer SR. An Osteopathic Modular Approach to Asthma: A Narrative Review. J Osteopath Med 2020; 120:774-782. [PMID: 32961555 DOI: 10.7556/jaoa.2020.121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Asthma is among of the first ailments documented in the existing academic literature as being successfully managed with osteopathic manipulative treatment (OMT) techniques. Time-efficient and well-tolerated OMT techniques have been gradually added to the literature to manage this increasingly prevalent disease. In this narrative review, the authors discuss previously-published literature describing the history, diagnosis, and management of asthma related to osteopathic principles and practices and OMT application. They also present current and newly-approved medical managements, including biologics and inhaled corticosteroids. This article also includes supplemental videos showcasing OMT techniques for asthma management, which were developed by the authors based on recommendations indicated in the literature.
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Moore DA, Nunns M, Shaw L, Rogers M, Walker E, Ford T, Garside R, Ukoumunne O, Titman P, Shafran R, Heyman I, Anderson R, Dickens C, Viner R, Bennett S, Logan S, Lockhart F, Thompson Coon J. Interventions to improve the mental health of children and young people with long-term physical conditions: linked evidence syntheses. Health Technol Assess 2020; 23:1-164. [PMID: 31122334 DOI: 10.3310/hta23220] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Although mental health difficulties can severely complicate the lives of children and young people (CYP) with long-term physical conditions (LTCs), there is a lack of evidence about the effectiveness of interventions to treat them. OBJECTIVES To evaluate the clinical effectiveness and cost-effectiveness of interventions aiming to improve the mental health of CYP with LTCs (review 1) and explore the factors that may enhance or limit their delivery (review 2). DATA SOURCES For review 1, 13 electronic databases were searched, including MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Science Citation Index. For review 2, MEDLINE, PsycINFO and CINAHL were searched. Supplementary searches, author contact and grey literature searches were also conducted. REVIEW METHODS The first systematic review sought randomised controlled trials (RCTs) and economic evaluations of interventions to improve elevated symptoms of mental ill health in CYP with LTCs. Effect sizes for each outcome were calculated post intervention (Cohen's d). When appropriate, random-effects meta-analyses produced pooled effect sizes (d). Review 2 located primary qualitative studies exploring experiences of CYP with LTCs, their families and/or practitioners, regarding interventions aiming to improve the mental health and well-being of CYP with LTCs. Synthesis followed the principles of metaethnography. An overarching synthesis integrated the findings from review 1 and review 2 using a deductive approach. End-user involvement, including topic experts and CYP with LTCs and their parents, was a feature throughout the project. RESULTS Review 1 synthesised 25 RCTs evaluating 11 types of intervention, sampling 12 different LTCs. Tentative evidence from seven studies suggests that cognitive-behavioural therapy interventions could improve the mental health of CYP with certain LTCs. Intervention-LTC dyads were diverse, with few opportunities to meta-analyse. No economic evaluations were located. Review 2 synthesised 57 studies evaluating 21 types of intervention. Most studies were of individuals with cancer, a human immunodeficiency virus (HIV) infection or mixed LTCs. Interventions often aimed to improve broader mental health and well-being, rather than symptoms of mental health disorder. The metaethnography identified five main constructs, described in an explanatory line of argument model of the experience of interventions. Nine overarching synthesis categories emerged from the integrated evidence, raising implications for future research. LIMITATIONS Review 1 conclusions were limited by the lack of evidence about intervention effectiveness. No relevant economic evaluations were located. There were no UK studies included in review 1, limiting the applicability of findings. The mental health status of participants in review 2 was usually unknown, limiting comparability with review 1. The different evidence identified by the two systematic reviews challenged the overarching synthesis. CONCLUSIONS There is a relatively small amount of comparable evidence for the effectiveness of interventions for the mental health of CYP with LTCs. Qualitative evidence provided insight into the experiences that intervention deliverers and recipients valued. Future research should evaluate potentially effective intervention components in high-quality RCTs integrating process evaluations. End-user involvement enriched the project. STUDY REGISTRATION This study is registered as PROSPERO CRD42011001716. FUNDING The National Institute for Health Research (NIHR) Health Technology Assessment programme and the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula.
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Affiliation(s)
- Darren A Moore
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Michael Nunns
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Liz Shaw
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Morwenna Rogers
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Erin Walker
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Tamsin Ford
- Child Mental Health Group, University of Exeter Medical School, Exeter, UK
| | - Ruth Garside
- The European Centre for Environment and Human Health, University of Exeter Medical School, Exeter, UK
| | - Obi Ukoumunne
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Penny Titman
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Roz Shafran
- University College London Institute of Child Health, London, UK
| | - Isobel Heyman
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Rob Anderson
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Chris Dickens
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Russell Viner
- University College London Institute of Child Health, London, UK
| | - Sophie Bennett
- University College London Institute of Child Health, London, UK
| | - Stuart Logan
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Fiona Lockhart
- Biomedical Research Centre Patient & Public Involvement Group, University College London Hospitals, London, UK
| | - Jo Thompson Coon
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
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Vargas PA. Spreading the Word: Comorbidity of Asthma and Depression Is Not Just the Product of a Vulnerable Personality. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:208-209. [PMID: 31950903 DOI: 10.1016/j.jaip.2019.07.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 01/19/2023]
Affiliation(s)
- Perla A Vargas
- School of Social and Behavioral Sciences, Arizona State University, Glendale, Ariz.
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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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Hsu CY, Lehman HK, Wood BL, Benipal J, Humayun Q, Miller BD. Comorbid Obesity and Depressive Symptoms in Childhood Asthma: A Harmful Synergy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:2689-2697. [PMID: 32304840 DOI: 10.1016/j.jaip.2020.03.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 03/03/2020] [Accepted: 03/19/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Overweight/obesity (OV/OB) and depression have each been separately associated with worsened childhood asthma severity and control. Pathways by which these factors may jointly affect childhood asthma have not been elucidated. OBJECTIVE To examine the interrelationship of OV/OB and depressive symptoms with childhood asthma and explore associated psychobiologic pathways. The present study investigated whether comorbid OV/OB and depressive symptoms are associated with impaired baseline lung function and increased airway resistance during emotional stress, and to assess whether such effects may be mediated by autonomic nervous system (ANS) dysregulation, specifically through predominance of vagal over sympathetic reactivity (vagal bias). METHODS A total of 250 children with asthma, aged 7 to 17, were assessed for OV/OB using body mass index, depressive symptoms using the Children's Depression Inventory (CDI), and asthma severity using National Asthma Education and Prevention Program Expert Panel Report 3 criteria. Baseline pulmonary function (forced expiratory volume in 1 second [FEV1]) was assessed. The film "E.T. the Extra-Terrestrial" was used in a laboratory paradigm to evoke emotional stress/arousal. Airway resistance (Rint) was measured before and after the film to determine changes in airway function. ANS reactivity was assessed by measuring parasympathetic/vagal and sympathetic reactivity throughout the film. RESULTS In OV/OB children with asthma, depressive symptoms predicted lower baseline FEV1 (β = -0.67, standard error [SE] = 0.24, P = .008), CDI predicted vagal bias under emotion stress/arousal (β = 0.27, SE = 0.09, P = .009), and vagal bias predicted increased Rint (β = 3.55, SE = 1.54, P = .023). CONCLUSION This study is the first to link OV/OB and depressive symptoms in their relationship to childhood asthma. In OV/OB children with asthma, depression may potentiate airway compromise, mediated by vagal bias. Use of antidepressant and anticholinergic therapies should be studied in this subgroup of patients.
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Affiliation(s)
- Chiun Yu Hsu
- Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY; Child and Family Asthma Studies Center, Oishei Children's Hospital, Buffalo, NY
| | - Heather K Lehman
- Child and Family Asthma Studies Center, Oishei Children's Hospital, Buffalo, NY; Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY; Allergy & Immunology, Oishei Children's Hospital, Buffalo, NY
| | - Beatrice L Wood
- Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY; Child and Family Asthma Studies Center, Oishei Children's Hospital, Buffalo, NY; Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY; Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Jaspreet Benipal
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Quratulain Humayun
- Child and Family Asthma Studies Center, Oishei Children's Hospital, Buffalo, NY
| | - Bruce D Miller
- Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY; Child and Family Asthma Studies Center, Oishei Children's Hospital, Buffalo, NY; Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY; Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY.
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45
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Tran L, Sharrad K, Kopsaftis Z, Stallman HM, Tai A, Spurrier N, Esterman A, Carson-Chahhoud K. Pharmacological interventions for the treatment of psychological distress in patients with asthma: a systematic review and meta-analysis. J Asthma 2020; 58:759-769. [PMID: 32065543 DOI: 10.1080/02770903.2020.1731826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective: To evaluate the effectiveness and safety of pharmacological interventions for the treatment of psychological distress in people with asthma.Data sources: Electronic searches were performed in Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PubMed/Medline, Embase, PsycInfo, Health Technology Assessment Database and Web of Science (inception to April 2019).Study selections: Included studies were randomized controlled trials (RCT) or controlled clinical trials investigating the effect of pharmacological interventions for psychological distress in people with asthma. Records were screened and data extracted by two independent authors into standardized pilot-tested extraction templates. Data was analyzed according to standard Cochrane methodology and entered into Review Manager Software version 5.3.Results: From 5,689 studies, six RCTs (n = 215) met inclusion criteria and were included in the systematic review, of which four studies were included in the meta-analysis. A meta-analysis of four studies (n = 158) indicated no evidence of an effect for selective serotonin reuptake inhibitors (Citalopram or Escitalopram) on reduction of psychological distress in adult patients with asthma. Similarly, antiepileptic medication (Levetiracetam) was no better than placebo in the treatment of psychological distress in people with asthma. Adverse events were poorly reported across all studies but were slightly increased among intervention participants compared to control participants.Conclusions: There was great heterogeneity between studies and overall poor methodological quality providing insufficient evidence to make recommendations for or against the use of pharmacotherapy in asthma patients with psychological distress. Further confirmatory trials are warranted to make recommendations for clinical practice.
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Affiliation(s)
- Liem Tran
- School of Medicine, Deakin University, Geelong, Australia.,Australian Centre for Precision Health, University of South Australia Cancer Research Institute, Adelaide, Australia.,School of Health Sciences, University of South Australia, Adelaide, Australia.,School of Medicine, University of Adelaide, Adelaide, Australia
| | - Kelsey Sharrad
- Australian Centre for Precision Health, University of South Australia Cancer Research Institute, Adelaide, Australia.,School of Health Sciences, University of South Australia, Adelaide, Australia.,School of Medicine, University of Adelaide, Adelaide, Australia
| | - Zoe Kopsaftis
- Australian Centre for Precision Health, University of South Australia Cancer Research Institute, Adelaide, Australia.,School of Health Sciences, University of South Australia, Adelaide, Australia.,School of Medicine, University of Adelaide, Adelaide, Australia.,Respiratory Medicine Unit, The Queen Elizabeth Hospital, Adelaide, Australia
| | - Helen M Stallman
- School of Social Sciences, University of the Sunshine Coast, Queensland, Australia.,Sunshine Coast Mind and Neuroscience - Thompson Institute, Queensland, Australia
| | - Andrew Tai
- Respiratory and Sleep Medicine, Women's & Children's Hospital, Adelaide, Australia.,Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Nicola Spurrier
- SA Health, Department for Health and Ageing, Adelaide, South Australia, Australia.,Department of Paediatrics and Child Health, Flinders University, Bedford Park, South Australia, Australia.,School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Adrian Esterman
- School of Nursing and Midwifery, University of South Australia, Adelaide, Australia.,UniSA Cancer Research Institute, University of South Australia, Adelaide, Australia
| | - Kristin Carson-Chahhoud
- Australian Centre for Precision Health, University of South Australia Cancer Research Institute, Adelaide, Australia.,School of Health Sciences, University of South Australia, Adelaide, Australia.,School of Medicine, University of Adelaide, Adelaide, Australia
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Akcan N, Bahceciler NN. Headliner in Physiology and Management of Childhood Asthma: Hypothalamic-Pituitary-Adrenal Axis. Curr Pediatr Rev 2020; 16:43-52. [PMID: 31738144 DOI: 10.2174/1573396315666191026100643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/23/2019] [Accepted: 10/23/2019] [Indexed: 02/06/2023]
Abstract
Asthma is the most common chronic inflammatory disease of children. Inhaled corticosteroids (ICS) are the cornerstone of asthma therapy which are the most effective, commonly used treatment of persistent asthma. Mostly, studies on the relationship between asthma and cortisol have focused on side effects of treatment. Recently, asthmatic patients not treated with ICS have been reported to have an attenuated activity and/or responsiveness of their Hypothalamic-Pituitary- Adrenal (HPA) axis. Moreover, it has been proposed that asthma worsening with stress may be due to a dysfunctional HPA axis, or cortisol insensitivity due to chronic psychological stress through impaired glucocorticoid receptor expression or function. Although long-term ICS treatment might produce adrenal suppression or iatrogenic Cushing syndrome, improvement of adrenal function has also been detected in some of asthmatic cases. Thus, the response scheme of HPA axis still contains undiscovered features in asthma. The management of asthma can be improved by increasing knowledge on the role of HPA axis in asthma pathophysiology. The risk for side effects of ICS can be minimized through increased awareness, early recognition of at-risk patients and regular patient follow-up. This review was written to draw attention to the role of HPA axis in both asthma and its treatment and to illustrate a follow up algorithm of HPA axis in the management of asthma.
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Affiliation(s)
- Nese Akcan
- Department of Pediatric Endocrinology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Nerin N Bahceciler
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Near East University, Nicosia, Cyprus
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Suldo SM, Thalji-Raitano A, Kiefer SM, Ferron JM. Conceptualizing High School Students' Mental Health Through a Dual-Factor Model. SCHOOL PSYCHOLOGY REVIEW 2019. [DOI: 10.17105/spr45-4.434-457] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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48
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Booster GD, Oland AA, Bender BG. Treatment Adherence in Young Children with Asthma. Immunol Allergy Clin North Am 2019; 39:233-242. [PMID: 30954173 DOI: 10.1016/j.iac.2018.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Treatment nonadherence in young children with asthma involves multiple factors and should be viewed within an ecological framework. Few interventions have targeted multiple bidirectional factors, however, and little research has examined which interventions may be most appropriate for young children. Additional research is needed to identify essential intervention components, and to determine how to sustain such interventions in at-risk communities. Pediatric psychologists, with training in psychosocial intervention, screening, and primary prevention models, may be uniquely equipped to partner with communities and medical settings to develop and sustain targeted interventions for young children with asthma.
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Affiliation(s)
- Genery D Booster
- National Jewish Health, Pediatric Behavioral Health, 1400 Jackson Street, Denver, CO 80206, USA.
| | - Alyssa A Oland
- National Jewish Health, Pediatric Behavioral Health, 1400 Jackson Street, Denver, CO 80206, USA
| | - Bruce G Bender
- National Jewish Health, Pediatric Behavioral Health, 1400 Jackson Street, Denver, CO 80206, USA
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Burg GT, Covar R, Oland AA, Guilbert TW. The Tempest: Difficult to Control Asthma in Adolescence. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 6:738-748. [PMID: 29747981 DOI: 10.1016/j.jaip.2018.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 02/02/2018] [Accepted: 02/03/2018] [Indexed: 02/06/2023]
Abstract
Severe asthma is associated with significant morbidity and is a highly heterogeneous disorder. Severe asthma in adolescence has some unique elements compared with the features of severe asthma a medical provider would see in younger children or adults. A specific focus on psychological issues and adherence highlights some of the challenges in the management of asthma in adolescents. Treatment of adolescents with severe asthma now includes 3 approved biologic phenotype-directed therapies. Therapies available to adults may be beneficial to adolescents with severe asthma. Research into predictors of specific treatment response by phenotypes is ongoing. Optimal treatment strategies are not yet defined and warrant further investigation.
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Affiliation(s)
- Gregory T Burg
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
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50
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Sohn KH, Song WJ, Kim SH, Jang HC, Kim KW, Chang YS. Chronic cough, not asthma, is associated with depression in the elderly: a community-based population analysis in South Korea. Korean J Intern Med 2019; 34:1363-1371. [PMID: 31610633 PMCID: PMC6823556 DOI: 10.3904/kjim.2018.187] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 09/27/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND/AIMS Depression and allergic diseases, including asthma, are frequently reported as comorbid conditions. However, their associations have been rarely examined in community-based elderly populations. METHODS The analyses were performed using the baseline data set of the Korean Longitudinal Study of Health and Aging, which consists of 1,000 elderly participants (aged > 65 years) randomly recruited from an urban community. Depression was assessed using the Geriatric Depression Scale, Center for Epidemiologic Studies Depression Scale, and Hamilton Rating Scale for Depression. Major and minor depressive disorders were diagnosed by psychiatrists. Allergic conditions were assessed using structured questionnaires, lung function, and skin prick test. Quality of life and comorbidities were assessed using structured questionnaires. RESULTS Prevalence of asthma and major depressive disorder were 5.4% and 5.3%, respectively. The rate of depression was not significantly different between the non-asthmatic and asthmatic groups. No correlation was observed between the scores obtained using the depression scales and self-reported asthma. However, chronic, frequent, and nocturnal cough were significantly associated with depression and scores obtained using the depression scales, which remained significant in multivariate logistic regression analyses (chronic cough: odds ratio [OR], 3.23; 95% confidence interval [CI], 2.57 to 12.74; p = 0.04). Rhinitis was independently associated with high Mini-Mental State Examination scores (OR, 1.11; 95% CI, 1.05 to 1.17; p < 0.001) and low 36-item short-form (OR, 0.96; 95% CI, 0.80 to 0.98; p = 0.002). CONCLUSION Depression may not be significantly associated with asthma and allergic diseases in elderly populations, but cough is a significant factor affecting depression.
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Affiliation(s)
- Kyoung-Hee Sohn
- Department of Internal Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Woo-Jung Song
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Allergy and Immunology, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sae-Hoon Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hak-Chul Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Endocrinology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yoon-Seok Chang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Correspondence to Yoon-Seok Chang, M.D. Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea Tel: +82-31-787-7023 Fax: +82-31-716-8349 E-mail:
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