哮喘症状负担：与哮喘严重程度以及焦虑和抑郁症状的关系。
Asthma symptom burden: relationship to asthma severity and anxiety and depression symptoms.
作者信息
Richardson Laura P, Lozano Paula, Russo Joan, McCauley Elizabeth, Bush Terry, Katon Wayne
机构信息
Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington 98115, USA.
出版信息
Pediatrics. 2006 Sep;118(3):1042-51. doi: 10.1542/peds.2006-0249.
OBJECTIVE
The purpose of this work was to examine the relationship between youth-reported asthma symptoms, presence of anxiety or depressive disorders, and objective measures of asthma severity among a population-based sample of youth with asthma.
METHODS
We conducted a telephone survey of 767 youth with asthma (aged 11-17 years) enrolled in a staff model health maintenance organization. The Diagnostic Interview Schedule for Children was used to diagnose Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, anxiety and depressive disorders; the Child Health Status-Asthma questionnaire (modified) was used to assess asthma symptoms; and automated administrative data were used to measure asthma treatment intensity and severity. Analyses of covariance were performed to determine whether the number of anxiety and depressive symptoms was related to the number of asthma symptoms. Logistic regression analyses were used to evaluate the strength of association between individual symptoms of asthma and the presence of an anxiety or depressive disorder and objective measures of asthma severity.
RESULTS
After adjusting for demographic characteristics, objective measures of asthma severity, medical comorbidity, and asthma treatment intensity, youth with > or = 1 anxiety or depressive disorder (N = 125) reported significantly more days of asthma symptoms over the previous 2 weeks than youth with no anxiety or depressive disorders. The overall number of reported asthma symptoms was significantly associated with the number of anxiety and depressive symptoms endorsed by youth. In logistic regression analyses, having an anxiety or depressive disorder was also strongly associated with each of the 6 asthma-specific symptoms, as well as the 5 related nonspecific somatic symptoms contained in the Child Health Status-Asthma questionnaire.
CONCLUSIONS
The presence of an anxiety or depressive disorder is highly associated with increased asthma symptom burden for youth with asthma.
目的
本研究旨在探讨在一个基于人群的哮喘青少年样本中，青少年自我报告的哮喘症状、焦虑或抑郁障碍的存在与哮喘严重程度客观指标之间的关系。
方法
我们对767名参加员工模式健康维护组织的哮喘青少年（年龄在11 - 17岁）进行了电话调查。使用儿童诊断访谈量表来诊断《精神疾病诊断与统计手册》第四版中的焦虑和抑郁障碍；使用儿童健康状况 - 哮喘问卷（修订版）来评估哮喘症状；并使用自动化管理数据来衡量哮喘治疗强度和严重程度。进行协方差分析以确定焦虑和抑郁症状的数量是否与哮喘症状的数量相关。使用逻辑回归分析来评估哮喘个体症状与焦虑或抑郁障碍的存在以及哮喘严重程度客观指标之间的关联强度。
结果
在调整了人口统计学特征、哮喘严重程度客观指标、合并症和哮喘治疗强度后，患有≥1种焦虑或抑郁障碍的青少年（N = 125）报告在过去2周内哮喘症状出现的天数显著多于无焦虑或抑郁障碍的青少年。报告的哮喘症状总数与青少年认可的焦虑和抑郁症状数量显著相关。在逻辑回归分析中，患有焦虑或抑郁障碍也与儿童健康状况 - 哮喘问卷中包含的6种特定哮喘症状以及5种相关的非特定躯体症状中的每一种都密切相关。
结论
对于患有哮喘的青少年，焦虑或抑郁障碍的存在与哮喘症状负担增加高度相关。
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