Goodwin Renee D, Fergusson David M, Horwood L John
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
Psychol Med. 2004 Nov;34(8):1465-74. doi: 10.1017/s0033291704002739.
The objectives of the study were to examine linkages between asthma and depressive and anxiety disorders in a birth cohort of over 1000 young persons studied to the age of 21 years. Specifically, the study aimed to ascertain the extent to which associations between asthma and depressive and anxiety disorders could be explained by non-observed fixed confounding factors.
Asthma and depressive and anxiety disorders were measured prospectively over the course of a 21-year longitudinal study. Fixed effects logistic regression models were used to determine the relationship between asthma and depressive and anxiety disorders, adjusting for potentially confounding factors.
Asthma in adolescence and young adulthood was associated with increased likelihood of major depression (OR 1.7, 95 % CI 1.3-2.3), panic attacks (OR 1.9, 95 % CI 1.3-2.8), and any anxiety disorder (OR 1.6, 95% CI 1.2-2.2). Associations between asthma and depressive and anxiety disorders were adjusted for confounding factors using a fixed effects regression model which showed that, after control for fixed confounding factors, asthma was no longer significantly related to major depression (OR 1.1), panic attacks (OR 1.1), or any anxiety disorder (OR 1.2). Additional post hoc analyses suggested that exposure to childhood adversity or unexamined familial factors may account for some of the co-morbidity of asthma and depressive and anxiety disorders.
These results confirm and extend previous findings by documenting elevated rates of depressive and anxiety disorders among young adults with asthma, compared with their counterparts without asthma, in the community. The weight of the evidence from this study suggests that associations between asthma and depressive and anxiety symptoms may reflect effects of common factors associated with both asthma and depressive and anxiety disorders, rather than a direct causal link. Future research is needed to identify the specific factors underlying these associations.
本研究的目的是在一个超过1000名年轻人的出生队列中，研究至21岁时哮喘与抑郁和焦虑症之间的联系。具体而言，该研究旨在确定哮喘与抑郁和焦虑症之间的关联在多大程度上可由未观察到的固定混杂因素来解释。
在一项为期21年的纵向研究过程中，对哮喘、抑郁和焦虑症进行前瞻性测量。使用固定效应逻辑回归模型来确定哮喘与抑郁和焦虑症之间的关系，并对潜在的混杂因素进行调整。
青少年期和青年期的哮喘与重度抑郁症（比值比1.7，95%置信区间1.3 - 2.3）、惊恐发作（比值比1.9，95%置信区间1.3 - 2.8）以及任何焦虑症（比值比1.6，95%置信区间1.2 - 2.2）的患病可能性增加相关。使用固定效应回归模型对哮喘与抑郁和焦虑症之间的关联进行混杂因素调整后发现，在控制固定混杂因素后，哮喘与重度抑郁症（比值比1.1）、惊恐发作（比值比1.1）或任何焦虑症（比值比1.2）不再显著相关。额外的事后分析表明，童年期逆境暴露或未研究的家族因素可能是哮喘与抑郁和焦虑症共病的部分原因。
这些结果通过记录社区中患有哮喘的年轻人与未患哮喘的同龄人相比，抑郁和焦虑症发病率升高，证实并扩展了先前的研究发现。本研究的证据表明，哮喘与抑郁和焦虑症状之间的关联可能反映了与哮喘以及抑郁和焦虑症相关的共同因素的影响，而非直接的因果联系。未来需要开展研究以确定这些关联背后的具体因素。
