Institute of Psychology, Heidelberg University, Heidelberg, Germany.
Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany.
Allergy. 2009 Oct;64(10):1444-1450. doi: 10.1111/j.1398-9995.2009.02019.x. Epub 2009 Feb 25.
Stressful life events can trigger asthma exacerbations, but could also contribute to the development of incident asthma. However, only few studies have investigated the association between stressful life events and adult asthma prospectively. Likewise, stress-related personality traits (e.g. neuroticism and extraversion) may increase asthma risk, but this has been examined in only one prospective study. We therefore aimed to investigate the association between neuroticism, extraversion, stressful life events and incident asthma.
A population-based sample of 5114 middle-aged adults completed questionnaires between 1992 and 1995. Among those alive in 2002/2003, 4010 (83%) were followed-up by questionnaires. Exposures of interest included neuroticism, extraversion and three stressful life events (unemployment, having broken off a life partnership and death of a close person). Associations with incident asthma were estimated by multivariable risk ratios (RR) and 95% confidence intervals (95% CI) using Poisson regression.
High vs low neuroticism predisposed to developing asthma (RR = 3.07, 95% CI = 1.71-5.48), but high extraversion did not (RR = 1.30, 95% CI = 0.79-2.15). Having broken off a life partnership significantly increased asthma risk (RR = 2.24, 95% CI = 1.20-4.21) in contrast to death of a close person (RR = 1.06, 95% CI = 0.64-1.75) or unemployment (RR = 1.65, 95% CI = 0.72-3.78).
High levels of neuroticism may increase the risk of asthma in middle-aged adults. Having broken off a life partnership was the only stressful event, which was associated with incident asthma. Synthesized with evidence from earlier studies, this could reflect that interpersonal conflicts may increase asthma risk, possibly along an immunological pathway.
生活压力事件可引发哮喘恶化，但也可能导致哮喘的发生。然而，仅有少数研究前瞻性地调查了生活压力事件与成人哮喘之间的关系。同样，与压力相关的个性特征（如神经质和外向性）可能会增加哮喘的风险，但这仅在一项前瞻性研究中进行了研究。因此，我们旨在调查神经质、外向性、生活压力事件与新发哮喘之间的关系。
一项基于人群的中年成年人样本在 1992 年至 1995 年期间完成了问卷调查。在 2002/2003 年仍在世的人群中，有 4010 人（83%）通过问卷调查进行了随访。感兴趣的暴露因素包括神经质、外向性和三种生活压力事件（失业、结束生命伴侣关系和亲密的人去世）。使用泊松回归估计与新发哮喘相关的多变量风险比（RR）和 95%置信区间（95%CI）。
与低神经质相比，高神经质易患哮喘（RR=3.07，95%CI=1.71-5.48），但高外向性不会（RR=1.30，95%CI=0.79-2.15）。与亲密的人去世（RR=1.06，95%CI=0.64-1.75）或失业（RR=1.65，95%CI=0.72-3.78）相比，结束生命伴侣关系显著增加了哮喘的风险（RR=2.24，95%CI=1.20-4.21）。
高水平的神经质可能会增加中年成年人患哮喘的风险。结束生命伴侣关系是唯一与新发哮喘相关的生活压力事件。与早期研究的证据综合在一起，这可能反映出人际冲突可能会增加哮喘的风险，可能是通过免疫途径。
