Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Pediatr Allergy Immunol. 2012 Dec;23(8):707-15. doi: 10.1111/pai.12000. Epub 2012 Sep 9.
It remains unclear whether anxiety and depressive symptoms are more prevalent in adolescents with asthma when compared with healthy individuals. This meta-analysis aimed to evaluate the difference in the aggregate prevalence of depressive and anxiety symptoms between adolescents with asthma and healthy controls and to explore the underlying moderators that potentially explain the heterogeneity of the effect size. A meta-analysis of published work was performed using the random effects model. The differences in aggregate prevalence of depressive and anxiety symptoms between adolescents with asthma and healthy controls were determined. Meta-regression and subgroup analysis were performed to identify factors that may contribute to heterogeneity. A total of eight studies were eligible for analysis. The aggregate prevalence of depressive and anxiety symptoms was significantly higher among 3546 adolescents with asthma than that of 24,884 controls (depression, 0.27; 95% CI, 0.18.6-0.39 vs. 0.13; 95% CI, 0.09-0.19; anxiety, 0.33; 95% CI, 0.19-0.52 vs. 0.21; 95% CI, 0.12-0.33). The risk of developing depression and anxiety is significantly higher among adolescents with asthma when compared with controls (depression: pooled odds ratio, 2.09; 95% CI, 1.65-2.64; p < 0.001; anxiety: pooled odds ratio, 1.83; 95% CI, 1.63-2.07; p < 0.001). Meta-regression revealed that the proportions of Caucasian (p = 0.008) and smokers (p < 0.001) were significant moderators which explained the significant heterogeneity when comparing the risk of developing depressive symptoms among adolescent asthma patients vs. controls while age, gender, and severity of asthma were not significant. Family doctors, pediatricians, and healthcare providers should formulate strategies to detect depressive and anxiety symptoms in adolescents with asthma and offer psychological interventions to reduce the burden of psychiatric comorbidity.
目前尚不清楚与健康个体相比，哮喘青少年是否更普遍存在焦虑和抑郁症状。本荟萃分析旨在评估哮喘青少年与健康对照者之间抑郁和焦虑症状的总体患病率差异，并探讨潜在解释效应大小异质性的调节因素。采用随机效应模型对已发表文献进行荟萃分析。确定哮喘青少年与健康对照者之间抑郁和焦虑症状总体患病率的差异。进行荟萃回归和亚组分析，以确定可能导致异质性的因素。共有 8 项研究符合分析条件。3546 名哮喘青少年的抑郁和焦虑症状总患病率明显高于 24884 名对照者（抑郁：0.27；95%CI，0.18-0.6-0.39 对 0.13；95%CI，0.09-0.19；焦虑：0.33；95%CI，0.19-0.52 对 0.21；95%CI，0.12-0.33）。与对照者相比，哮喘青少年发生抑郁和焦虑的风险明显更高（抑郁：合并优势比，2.09；95%CI，1.65-2.64；p<0.001；焦虑：合并优势比，1.83；95%CI，1.63-2.07；p<0.001）。荟萃回归显示，白种人（p=0.008）和吸烟者（p<0.001）的比例是显著的调节因素，当比较哮喘青少年与对照者发生抑郁症状的风险时，这些因素解释了显著的异质性，而年龄、性别和哮喘严重程度则不显著。家庭医生、儿科医生和医疗保健提供者应制定策略，以检测哮喘青少年的抑郁和焦虑症状，并提供心理干预，以减轻精神共病的负担。
