Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital System, Singapore.
J Adolesc Health. 2014 Aug;55(2):267-75. doi: 10.1016/j.jadohealth.2014.01.007. Epub 2014 Mar 12.
Psychiatric comorbidity is reported to be common among adolescents with asthma, but little is known about its underlying psychological factors.
This study explored the profile of anxiety and depressive comorbidities among adolescents with well-controlled and poorly controlled asthma and the contribution of neuroticism and perceived stress.
The Revised Child Anxiety and Depression Scale, Neuroticism subscale of Big Five Inventory, Perceived Stress Scale, and Asthma Control Test were administered to 198 adolescents (aged 12-19 years) with well-controlled (n = 137) and poorly controlled asthma (n = 61) as well as 171 healthy neighborhood controls.
Adolescents with poorly controlled asthma, compared with well-controlled asthma patients and healthy controls, had higher scores of depression (p = .006), panic attacks (p = .002), total anxiety (p = .038), and total internalizing symptoms (p = .017), after adjusting for gender, age, ethnicity, smoking status, and family housing type. Adolescents with asthma had higher neuroticism (p = .025), perceived stress (p = .022), and body mass index (p = .006) and lower self-rated health (p < .001) than healthy controls. No significant differences in psychiatric comorbidity scores were observed after accounting for differences in underlying psychological and physical factors. Among asthma patients, increased asthma control was associated with decreased scores of psychiatric comorbidity (p < .01), but the association was not significant after allowing for decreased neuroticism and perceived stress.
The diagnosis of asthma and poor asthma control in adolescents is associated with excess psychiatric comorbidity, which is likely due to increased neuroticism and perceived stress.
据报道，精神共病在哮喘青少年中较为常见，但对于其潜在的心理因素知之甚少。
本研究探讨了控制良好和控制不佳的哮喘青少年中焦虑和抑郁共病的特征，以及神经质和感知压力的作用。
对 198 名青少年（12-19 岁）进行了修订版儿童焦虑和抑郁量表、大五人格量表神经质分量表、感知压力量表和哮喘控制测试，其中包括控制良好（n=137）和控制不佳（n=61）的哮喘患者以及 171 名健康的同龄对照组。
与控制良好的哮喘患者和健康对照组相比，控制不佳的哮喘青少年的抑郁（p=0.006）、惊恐发作（p=0.002）、总焦虑（p=0.038）和总内化症状（p=0.017）得分更高，调整性别、年龄、种族、吸烟状况和家庭住房类型后。哮喘青少年的神经质（p=0.025）、感知压力（p=0.022）、体重指数（p=0.006）更高，自我健康评价（p<0.001）更低。在考虑潜在的心理和生理因素差异后，精神共病评分无显著差异。在哮喘患者中，哮喘控制的改善与精神共病评分的降低相关（p<0.01），但在考虑神经质和感知压力降低后，相关性不显著。
青少年哮喘的诊断和较差的哮喘控制与过多的精神共病有关，这可能是由于神经质和感知压力增加所致。
