Katon Wayne, Lozano Paula, Russo Joan, McCauley Elizabeth, Richardson Laura, Bush Terry
Department of Psychiatry, University of Washington School of Medicine, Seattle, Washington 98195-6560, USA.
J Adolesc Health. 2007 Nov;41(5):455-63. doi: 10.1016/j.jadohealth.2007.05.023. Epub 2007 Sep 4.
To determine the prevalence of anxiety and depressive disorders in youth with asthma compared with a control sample of youth and to determine the sociodemographic and clinical characteristics associated with having one or more anxiety/depressive disorders among youth with asthma.
A telephone interview was offered to all youth aged 11-17 years with asthma (N = 781) and a random sample of similar aged controls (N = 598) enrolled in a Health Maintenance Organization. The C-DISC-4.0 was used to diagnose anxiety and depressive disorders and reliable and valid questionnaires were used to assess severity of anxiety and depressive symptoms. Automated diagnostic, pharmacy and health use data were used to measure asthma treatment intensity, asthma severity and nonasthmatic medical comorbidity. One parent was interviewed to assess sociodemographic variables, child/adolescent psychiatric symptoms and to confirm the asthma diagnosis.
In all, 16.3% of youth with asthma compared with 8.6% of youth without asthma met DSM-IV criteria for one or more anxiety and depressive disorders (OR = 1.92, 95% CI = 1.13-3.28). Independent factors associated with a significantly higher likelihood of meeting criteria for one or more anxiety or depressive disorders included female gender [OR = 1.96 (95% CI = 1.27, 3.03)], living in a single-parent household, [OR = 1.96 (95% CI = 1.26, 3.07)], more parent-reported externalizing behaviors [OR = 1.03 (95% CI = 1.01, 1.05)], more recent diagnosis of asthma [OR = 0.94 (95% CI = 0.89, 0.98)], and more impairment on the asthma physical health scale [OR = 0.95 (95% CI = 0.94, 0.96)].
Youth with asthma have an almost twofold higher prevalence of comorbid DSM-IV anxiety and depressive disorders compared with control youth. Clinical factors associated with meeting criteria for one or more anxiety and depressive included more recent asthma diagnosis, more impairment on the asthma physical health scale, and increased externalizing behaviors.
确定哮喘青少年中焦虑症和抑郁症的患病率，并与青少年对照样本进行比较，同时确定哮喘青少年中与患有一种或多种焦虑/抑郁障碍相关的社会人口学和临床特征。
对所有年龄在11 - 17岁的哮喘青少年（N = 781）以及参与健康维护组织的随机抽取的年龄相仿的对照样本（N = 598）进行电话访谈。使用儿童青少年诊断访谈量表第4版（C - DISC - 4.0）来诊断焦虑症和抑郁症，并使用可靠有效的问卷来评估焦虑和抑郁症状的严重程度。利用自动化诊断、药房和健康使用数据来衡量哮喘治疗强度、哮喘严重程度和非哮喘性合并症。对一位家长进行访谈，以评估社会人口学变量、儿童/青少年精神症状并确认哮喘诊断。
总体而言，符合一种或多种焦虑症和抑郁症DSM - IV标准的哮喘青少年比例为16.3%，而无哮喘青少年的这一比例为8.6%（比值比[OR] = 1.92，95%置信区间[CI] = 1.13 - 3.28）。与符合一种或多种焦虑或抑郁障碍标准的可能性显著更高相关的独立因素包括女性性别[OR = 1.96（95% CI = 1.27，3.03）]、生活在单亲家庭[OR = 1.96（95% CI = 1.26，3.07）]、更多家长报告的外化行为[OR = 1.03（95% CI = 1.01，1.05）]、哮喘诊断时间更近[OR = 0.94（95% CI = 0.89，0.98）]以及哮喘身体健康量表上的功能损害更严重[OR = 0.95（95% CI = 0.94，0.96）]。
与对照青少年相比，哮喘青少年共病DSM - IV焦虑症和抑郁症的患病率几乎高出一倍。与符合一种或多种焦虑和抑郁标准相关的临床因素包括哮喘诊断时间更近、哮喘身体健康量表上的功能损害更严重以及外化行为增加。
