1
|
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.
Collapse
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
| |
Collapse
|
2
|
Kim SY, Choi SH, Kim JD, Sol IS, Kim MJ, Kim YH, Jung YC, Sohn MH, Kim KW. Korean Youth with Comorbid Allergic Disease and Obesity Show Heightened Psychological Distress. J Pediatr 2019; 206:99-104.e4. [PMID: 30466789 DOI: 10.1016/j.jpeds.2018.10.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/20/2018] [Accepted: 10/23/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To explore psychological distress in Korean adolescents having allergic disease comorbid with obesity. STUDY DESIGN A total of 703 869 adolescents who completed the Korean Youth Risk Behavior Web-based Survey between 2007 and 2016 were analyzed. Participants were divided into 4 groups-healthy control, allergic disease only, obesity only, and comorbidity of allergic disease and obesity-and compared them to determine whether they showed differences in mental health. RESULTS Adolescents with both atopic dermatitis and obesity had significantly greater odds of experiencing unhappiness (OR, 1.17), stress (OR, 1.32), and suicidal ideation (OR, 1.25) than those without both conditions. The same was true of adolescents with obesity and allergic rhinitis (OR, 1.21, 1.37, and 1.27, respectively) or bronchial asthma (OR, 1.37, 1.39, and 1.37). The comorbidity groups also showed significantly greater odds of stress and suicidal ideation than the allergic disease-only (atopic dermatitis with obesity, 1.21 and 1.15, respectively; allergic rhinitis with obesity, 1.11 and 1.09; bronchial asthma with obesity, 1.17 and 1.14) and obesity-only groups (atopic dermatitis with obesity, 1.13 and 1.09; allergic rhinitis with obesity, 1.18 and 1.10; bronchial asthma with obesity, 1.18 and 1.21). CONCLUSIONS Allergic disease and obesity negatively and additively influence mental health in adolescents.
Collapse
Affiliation(s)
- Soo Yeon Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sun Ha Choi
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong Deok Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - In Suk Sol
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Jung Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yoon Hee Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Chul Jung
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Myung Hyun Sohn
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
3
|
Abstract
OBJECTIVE Adolescents from Puerto Rican backgrounds are found to have higher rates of obesity than adolescents from other ethnic groups in the US. The objective of this study is to examine whether sleeping the recommended number of hours and depression or anxiety disorder are independently related to risk for obesity in a sample of Island Puerto Rican adolescents, and whether the association between sleep and obesity is moderated by depression or anxiety disorder. METHODS Data from the study were derived from the third wave of an island wide probability sample of Puerto Rican youth residing on the Island, 10-25 years of age (N = 825), with a response rate of 79.59%. The current study focuses on youth 10 to 19 years of age (n = 436). RESULTS In this sample, youth who slept less than the recommended number of hours (defined as 7-9 h per night) had a significantly increased risk for obesity and were three times as likely to be obese. Youth who met criteria for a depressive/anxiety disorder were almost 2.5 times as likely to be obese. However, the presence of an anxiety/depressive disorders did not moderate the association between sleeping the recommended number of hours and risk for obesity. CONCLUSION Sleeping less than the recommended number of hours may be an important risk factor for obesity status in Island Puerto Rican youth. These findings suggest that attention to healthy sleep behaviors and a sleep environment that promotes high quality sleep may be important for Puerto Rican adolescents at risk for obesity.
Collapse
|
4
|
Zorrilla CD, Sánchez I, Mosquera AM, Sierra D, Pérez LAL, Rabionet S, Rivera-Viñas J. Improved Infant Outcomes with Group Prenatal Care in Puerto Rico. SOURCE JOURNAL OF OBSTETRICS AND GYNAECOLOGY 2017; 1:http://sourcejournals.com/journal/source-journal-of-obstetrics-and-gynaecology-sjog/current-issue/. [PMID: 30159551 PMCID: PMC6110527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To evaluate the impact of group prenatal care (Centering Pregnancy) on the rate of Preterm Birth (PTB) and low birth weight. Women were enrolled into Centering Pregnancy (Transformación Prenatal) if they fell in the category of poverty, and had at least one risk for PTB according to known risk factors for low birth weight or PTB. METHODS Mother's age, parity, risk factors, prenatal/delivery complications, infants' Gestational Age (GA), birth weight, Apgar scores, delivery route, indications for delivery, and use of Neonatal Intensive Care Unit (NICU) were abstracted from charts of mothers who received group or traditional care at the University Hospital in San Juan, PR. RESULTS More infants were born at term if the mothers received Centering Pregnancy. The mean birth weight and gestational age of the infants were higher (6.59 vs. 6.33 lbs. and 37.8 vs. 36.8 weeks) than for those in traditional care. Centering Pregnancy also had lower rates of preterm birth (27.7% vs. 34.1%) and births earlier than 31 weeks (2.8% vs. 9.9%). All were statistically significant (P<0.05). CONCLUSIONS We successfully implemented group prenatal care (Centering Pregnancy) for the first time in PR in a complex environment: tertiary care hospital with a high-risk prenatal clinic. Despite having known risk factors for preterm birth, the mothers in Centering Pregnancy had better outcomes. In an environment of adverse determinants of health, the program was effective in reducing the odds for adverse infant outcomes early in life and demonstrating that innovative models of health care can improve such outcomes.
Collapse
Affiliation(s)
- Carmen D Zorrilla
- Obstetrics and Gynecology Department, UPR School of Medicine, Puerto Rico
| | - Isalis Sánchez
- Department of Human Genetics, Miller School of Medicine, University of Miami, USA
| | - Ana María Mosquera
- Maternal Infant Studies Center (CEMI), Obstetrics and Gynecology Department, UPR School of Medicine, Puerto Rico
| | - Dianca Sierra
- Maternal Infant Studies Center (CEMI), Obstetrics and Gynecology Department, UPR School of Medicine, Puerto Rico
| | - Lyz Annette López Pérez
- Maternal Infant Studies Center (CEMI), Obstetrics and Gynecology Department, UPR School of Medicine, Puerto Rico
| | - Silvia Rabionet
- Maternal Infant Studies Center (CEMI), Obstetrics and Gynecology Department, UPR School of Medicine, Puerto Rico
| | - Juana Rivera-Viñas
- Maternal Infant Studies Center (CEMI), Obstetrics and Gynecology Department, UPR School of Medicine, Puerto Rico
| |
Collapse
|
5
|
[Probable Mental Health Disorders Prevalence in Children With Chronic Conditions. Results From the National Mental Health Survey of Colombia 2015]. ACTA ACUST UNITED AC 2016; 45 Suppl 1:135-140. [PMID: 27993248 DOI: 10.1016/j.rcp.2016.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 06/28/2016] [Accepted: 08/25/2016] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The prevalence of chronic conditions is increasing globally and this phenomenon covers pediatric populations. There is a relationship between chronic conditions and mental health problems, which has been insufficiently studied in the case of children. OBJECTIVE To measure the frequency of problems and mental disorders in the Colombian population between 7 and 11 years, depending on the presence or absence of chronic conditions. METHODS The information pertains to the National Survey of Mental Health of Colombia 2015, an observational cross-sectional nationally representative for the group between 7 and 11 years old. Mental problems where measure with the Reporting Questionnaire for Children (RQC), the 12 month prevalence of seven mental disorders were assessed using the Diagnostic Interview Schedule for Children Version parents (DISC-P) and a list of chronic conditions. Univariate and stratification analysis of the data were performed. RESULTS 41.6% of the children with no chronic conditions, 56.7% of the children with 1 chronic condition and 70.8% in those with 2 or more have at least one RQC symptom; the highest prevalence of mental health symptoms are those with chronic inflammatory lung disease, followed by diabetes mellitus and allergies. The prevalence of one or more mental disorders in children without chronic conditions is 3.1% while those with at least 1 is 13.8%. CONCLUSIONS A higher prevalence of mental disorders in children and its association with chronic conditions justifies further studies that address this issue and develop strategies with multidisciplinary interventions.
Collapse
|
6
|
Del Giacco SR, Cappai A, Gambula L, Cabras S, Perra S, Manconi PE, Carpiniello B, Pinna F. The asthma-anxiety connection. Respir Med 2016; 120:44-53. [PMID: 27817815 DOI: 10.1016/j.rmed.2016.09.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 09/16/2016] [Accepted: 09/20/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND The literature reports a significant association between various mental disorders and asthma, in particular depression and/or anxiety, with some more robust data regarding anxiety disorders. However, the nature of this association remains largely unclear. OBJECTIVES (1) To test the hypothesis of a specific association of anxiety and depressive disorder (according to the DSM-IV) with asthma and (2) to test the bidirectional hypothesis of causality between asthma and psychiatric disorders. METHODS Ninety-six adults were compared with 96 control subjects matched according to main socio-demographic variables (i.e., gender, age, marital status, cohabiting/non-cohabiting, and BMI). Subjects with asthma were divided according to GINA and ACT classifications. All subjects underwent Structured Clinical Interviews for DSM-IV Axis I (SCID-I) diagnosis. RESULTS Significant association between asthma and lifetime anxiety disorders emerged (OR 3.03; p = 0.003); no significant association with other psychiatric diagnosis emerged. Moreover, lifetime and current anxiety were associated with asthma severity levels (p < 0.01 and p = 0.001 based on age). Asthma preceded anxiety in 48% of cases; in 52% of cases, anxiety preceded asthma, without significant group differences. The risk of asthma, particularly of severe, uncontrolled forms (p < 0.01), resulted higher in lifetime anxiety disorder patients (p = 0.003 and p = 0.001 based on age at onset). Current anxiety increased the risk of asthma, and that of an uncontrolled form (p < 0.05). Asthma increased the risk of lifetime anxiety disorders (p = 0.002 and p = 0.018 using ages). Intermittent asthma increased the risk of lifetime and current anxiety disorders (p < 0.01). CONCLUSIONS Anxiety disorders, in particular Lifetime Anxiety Disorders, represent the only psychiatric disorder significantly associated with asthma, with a possible bidirectional, anxiety-asthma relationship, each of which can be caused or result from the other.
Collapse
Affiliation(s)
- Stefano R Del Giacco
- Department of Medical Sciences "M. Aresu", Allergy and Clinical Immunology Unit, University of Cagliari, Cagliari, Italy.
| | - Alessandra Cappai
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Luisanna Gambula
- Department of Medical Sciences "M. Aresu", Allergy and Clinical Immunology Unit, University of Cagliari, Cagliari, Italy
| | - Stefano Cabras
- Department of Mathematics and Informatics, University of Cagliari, Cagliari, Italy; Department of Statistics, Carlos III University of Madrid, Madrid, Spain
| | - Silvia Perra
- Department of Mathematics and Informatics, University of Cagliari, Cagliari, Italy
| | - Paolo Emilio Manconi
- Department of Medical Sciences "M. Aresu", Allergy and Clinical Immunology Unit, University of Cagliari, Cagliari, Italy
| | - Bernardo Carpiniello
- Department of Public Health, Psychiatry Unit, University of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Department of Public Health, Psychiatry Unit, University of Cagliari, Cagliari, Italy
| |
Collapse
|
7
|
Abstract
This review focuses on obesity, asthma and mental health functioning as salient health issues affecting Hispanic youth. Burden of these conditions and consequences for adult health are also discussed. Hispanic youth are affected by obesity at an early age; the prevalence of obesity among Hispanic children 6-11 years old is twice as high as the prevalence for non-Hispanic White children of the same age, but among 2-5 years old is 4 times higher. Asthma disproportionally affects certain Hispanic groups, notably children of Puerto Rican ancestry, and the comorbidity of asthma and obesity is an emerging health issue. Another area of concern is the scant data on mental health functioning among Hispanic youth. Research on Hispanic youth mental health have reported high rates of depressive symptomatology and high rates of alcohol use among Hispanic adolescents but despite these findings, they have inadequate access to mental health services. This review highlights the need for better data to gain a better understanding of the health status of Hispanic youth and help develop preventive programs that addresses the need of this population. Improving access to health services, in particular mental health services, is also a crucial aspect.
Collapse
Affiliation(s)
- Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine
| | - Deepa Rastogi
- Department of Pediatrics, Albert Einstein College of Medicine
| | | |
Collapse
|
8
|
Elías-Boneta AR, Toro MJ, Garcia O, Torres R, Palacios C. High prevalence of overweight and obesity among a representative sample of Puerto Rican children. BMC Public Health 2015; 15:219. [PMID: 25885462 PMCID: PMC4358900 DOI: 10.1186/s12889-015-1549-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 02/16/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The prevalence of childhood overweight and obesity has become a public health problem worldwide. The objectives of the study were: 1) to establish the BMI prevalence in 12-year olds residing in Puerto Rico, and 2) to determine BMI differences by sex, public-private school type, and geographic regions. METHODS Data was obtained from an island-wide probabilistic stratified sample of 1,582 twelve-year-olds (53% girls and 47% boys). The BMI was determined using the National Health and Nutrition Examination Survey procedures. Children were categorized as underweight, healthy weight, overweight or obese using the Center for Disease Control and Prevention's age and gender specific growth charts. A logistic regression model was used to estimate BMI category prevalence. Odds ratios were calculated using a multinomial regression. RESULTS In this study, 18.8% of the children were overweight and 24.3% were obese. A higher prevalence of obesity was observed in boys as compared to girls, 28.2% vs. 20.2%, respectively. The estimated prevalence of overweight and obesity in children from public schools was lower than for those from private schools. After adjusting for type of school and region, boys had a significantly higher risk of being obese (64%) as compared to girls. In public schools, boys had a lower prevalence of being overweight while girls had a higher prevalence compared to children attending private schools. Girls attending private schools had a higher obesity prevalence (27.8%) compared to girls from public schools (19.8%). The prevalence of underweight (2.7%) is slightly lower than in the United States. CONCLUSIONS The prevalence of overweight and obesity of 12-year-olds residing in PR was 18.8% and 24.3%, respectively; higher than in the U.S. (by groups). Boys were at higher risk of obesity than girls. There is an urgent need to implement public health policies/programs to reduce the prevalence of overweight and obesity in children in PR.
Collapse
Affiliation(s)
- Augusto R Elías-Boneta
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico.
| | - Milagros J Toro
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico.
| | - Omar Garcia
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico.
| | - Roxana Torres
- School of Public Health, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico.
| | - Cristina Palacios
- School of Public Health, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico.
| |
Collapse
|
9
|
Dart AB, Wicklow BA, Sellers EA, Dean HJ, Malik S, Walker J, Chateau D, Blydt-Hansen TD, McGavock JM. The Improving Renal Complications in Adolescents With Type 2 Diabetes Through the REsearch (iCARE) Cohort Study: Rationale and Protocol. Can J Diabetes 2014; 38:349-55. [DOI: 10.1016/j.jcjd.2014.07.224] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 07/30/2014] [Accepted: 07/31/2014] [Indexed: 12/22/2022]
|
10
|
Kapadia SG, Wei C, Bartlett SJ, Lang J, Wise RA, Dixon AE. Obesity and symptoms of depression contribute independently to the poor asthma control of obesity. Respir Med 2014; 108:1100-7. [PMID: 24947900 DOI: 10.1016/j.rmed.2014.05.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 05/23/2014] [Accepted: 05/26/2014] [Indexed: 11/26/2022]
Abstract
UNLABELLED Obesity is a major risk factor for poorly controlled asthma, but the reasons for poor asthma control in this patient population are unclear. Symptoms of depression have been associated with poor asthma control, and increase with higher body mass index (BMI). The purpose of this study was to assess whether depressive symptoms underlie poor asthma control in obesity. METHODS We determined the relationship between BMI, psychological morbidity and asthma control at baseline in a well-characterized patient population participating in a clinical trial conducted by the American Lung Association-Asthma Clinical Research Centers. RESULTS Obese asthmatic participants had increased symptoms of depression (Center for Epidemiologic Studies Depression Scale score in lean 10.1 ± 8.1, overweight 10.0 ± 8.1, obese 12.4 ± 9.9; p = 0.03), worse asthma control (Juniper Asthma Control Questionnaire score in lean 1.43 ± 0.68, overweight 1.52 ± 0.71, obese 1.76 ± 0.75; p < 0.0001), and worse asthma quality of life (scores in lean 5.21 ± 1.08, overweight 5.08 ± 1.05, obese 4.64 ± 1.09; p < 0.0001). Asthmatics with obesity and those with symptoms of depression both had a higher risk of having poorly controlled asthma (adjusted odds ratio of 1.83 CI 1.23-3.52 for obesity, and 2.08 CI 1.23-3.52 for depression), but there was no interaction between the two. CONCLUSION Obesity and symptoms of depression are independently associated with poor asthma control. As depression is increased in obese asthmatics it may be an important co-morbidity contributing to poor asthma control in this population, but factors other than depression also contribute to poor asthma control in obesity.
Collapse
Affiliation(s)
- S G Kapadia
- University of Vermont College of Medicine, Burlington, VT, USA
| | - C Wei
- Johns Hopkins University, Baltimore, MD, USA
| | | | - J Lang
- Nemours Children's Hospital, Orlando, FL, USA
| | - R A Wise
- Johns Hopkins University, Baltimore, MD, USA
| | - A E Dixon
- University of Vermont College of Medicine, Burlington, VT, USA.
| | | |
Collapse
|
11
|
Chen MH, Su TP, Chen YS, Hsu JW, Huang KL, Chang WH, Chen TJ, Bai YM. Higher risk of mood disorders among adolescents with ADHD and asthma: a nationwide prospective study. J Affect Disord 2014; 156:232-5. [PMID: 24280383 DOI: 10.1016/j.jad.2013.10.053] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 10/21/2013] [Accepted: 10/21/2013] [Indexed: 01/29/2023]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) and asthma are commonly comorbid together, and are associated with an increased risk of development of mood disorders separately. However, there has been no study investigating the comorbid effect of these two disorders on developing mood disorder. METHODS Using the National Health Insurance Research Database, adolescents with ADHD-alone, asthma-alone, ADHD comorbid with asthma, and age-/gender-matched (1:4) controls were recruited in 2003. Subjects who developed major depression, any depressive disorder, or bipolar disorder during the follow-up period (2003-2010) were identified. RESULTS In all, 1172 adolescents with ADHD-alone, 487 with asthma-alone, 238 with ADHD+asthma, and 7552 controls were recruited in 2003. Adolescents with ADHD+asthma and those with ADHD-alone, but not those with asthma-alone, had an elevated risk of developing major depression (hazard ratio [HR]: 10.25, 95% confidence interval [CI]: 3.86-27.19; HR: 8.64, 95%CI: 5.00-14.93; HR: 2.11, 95%CI: 0.71-6.23) and bipolar disorder (HR: 31.25, 95%CI: 8.87-110.12; HR: 10.42, 95%CI: 4.60-23.63; HR: 1.91, 95%CI: 0.24-15.32) compared to the control group. DISCUSSION Our results showed that ADHD adolescents had an increased risk of developing both unipolar depression and bipolar depression in their later life, and that the comorbidity of asthma with a synergistic effect increased this risk further. The underlying pathophysiology among ADHD, asthma, and mood disorders needs further investigation.
Collapse
Affiliation(s)
- Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Ying-Sheue Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Wen-Han Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 11217, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
12
|
Abstract
BACKGROUND Few population-based studies have assessed health outcomes and health care access and use among youth in the US Commonwealth of Puerto Rico. METHODS Data are from an island population-based sample of 337 youth, 10 to 17 years old, who participated in the Asthma, Depression, and Anxiety in Puerto Rican Youth Study. In-person interviews with youth and caregivers assessed self-rated physical and mental health, weight status, diagnosed health conditions, and health care access and use. RESULTS Island Puerto Rican youth report slightly worse physical and mental health than mainland youth. Puerto Rican youth have high rates of asthma, headaches, and stomachaches. Also, 6 in 10 island youth use public health insurance, and 1 in 3 regularly receive care at the emergency department. CONCLUSIONS Island Puerto Rican youth are at a health disadvantage compared with mainland youth. Public health research is needed to fully understand and combat health challenges among Puerto Rican youth.
Collapse
Affiliation(s)
- Brent A Langellier
- Department of Community Health Sciences, UCLA School of Public Health, Los Angeles, CA 90095-1772, USA.
| | - Molly A Martin
- Rush University Medical Center, Department of Preventive Medicine
| | - Glorisa Canino
- University of Puerto Rico, School of Medicine, Behavioral Sciences Research Institute
| | | | | |
Collapse
|