Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Ann Allergy Asthma Immunol. 2020 Oct;125(4):393-398. doi: 10.1016/j.anai.2020.07.001. Epub 2020 Jul 9.
First, to review and critically discuss published evidence on psychosocial stressors, stress, and asthma in adolescents and, then, discuss potential future directions in this field.
The data source is the National Library of Medicine (PubMed database).
A literature search was conducted for human studies on stressors or stress and asthma between 2000 and 2020. Studies that were published in English, contained a full text, and included adolescents were considered for inclusion in this review.
Compared with the available body of evidence in children and adults, relatively few studies have been published in adolescents. Current evidence suggests that exposure to stressors (at the individual, family, and community levels) or stress (acute and chronic) is associated with asthma and worse asthma outcomes, but such evidence must be cautiously interpreted owing to limitations in the design or the analytical approach of the published studies.
Future large studies with a prospective design should determine whether and how stressors or stress causes or worsens asthma in adolescents. At present, clinicians should assess exposure to stressors (eg, violence or abuse) and screen for anxiety and depressive disorders when caring for adolescents with asthma in addition to providing referrals to social workers or mental health professionals when appropriate. Public health policies are needed to reduce psychosocial stressors, such as gun violence and racism, in adolescents.
首先，回顾和批判性地讨论已发表的关于青少年心理社会应激源、应激和哮喘的证据，然后讨论该领域未来的潜在方向。
资料来源于美国国立医学图书馆（PubMed 数据库）。
对 2000 年至 2020 年间应激源或应激与哮喘的人类研究进行了文献检索。只有发表在英语期刊、全文可获取并纳入青少年的研究才被考虑纳入本综述。
与儿童和成人现有证据相比，在青少年中发表的研究相对较少。目前的证据表明，暴露于应激源（个体、家庭和社区层面）或应激（急性和慢性）与哮喘和更差的哮喘结局相关，但由于发表研究的设计或分析方法存在局限性，必须谨慎解释此类证据。
目前，临床医生在护理哮喘青少年时，除了酌情将其转介给社会工作者或心理健康专业人员外，还应评估其应激源（例如，暴力或虐待）暴露情况，并筛查焦虑和抑郁障碍。未来应开展具有前瞻性设计的大型研究，以确定应激源或应激是否以及如何导致或加重青少年的哮喘。需要制定公共卫生政策来减少青少年的心理社会应激源，如枪支暴力和种族主义。
