Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX.
Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX.
J Allergy Clin Immunol Pract. 2021 Jun;9(6):2399-2405. doi: 10.1016/j.jaip.2021.02.043. Epub 2021 Mar 4.
Pediatric asthma is associated with increased health services utilization, missed school days, and diminished quality of life. Children with asthma also report more frequent depressive and anxiety symptoms than children without asthma, which may further worsen asthma outcomes.
The current study investigated the relationship between depressive and anxiety symptoms and 4 asthma outcomes (asthma control, asthma severity, lung function, and asthma-related quality of life) in children (N = 205) with moderate to severe persistent asthma.
The data were analyzed using a canonical correlation analysis, a multivariate framework that allows examination of all variables of interest in the same model.
We found a statistically significant relationship between symptoms of depression and anxiety and asthma outcomes (1 - Λ = .372; P < .001). A large effect size suggests that 37.2% of variance is shared between depression and anxiety symptoms and 4 asthma outcomes (particularly asthma control and asthma-related quality of life) in the overall sample. Among girls (vs. boys), asthma control (measured by the Asthma Control Test) emerged as a stronger contributor to asthma outcomes compared with boys.
These results suggest that psychiatric symptoms, especially anxiety, are associated with poor asthma-related quality of life, and more negative perception of asthma control in girls compared with boys (with no observed sex difference in physiological lung function). Clinicians should consider incorporating questions about psychiatric symptoms as part of routine asthma management, and focus patient education on unique differences in which boys and girls perceive their asthma symptoms.
小儿哮喘与卫生服务利用率增加、缺课和生活质量下降有关。患有哮喘的儿童比没有哮喘的儿童报告更多的抑郁和焦虑症状，这可能进一步恶化哮喘的结果。
本研究调查了患有中重度持续性哮喘的儿童（N=205）的抑郁和焦虑症状与 4 项哮喘结果（哮喘控制、哮喘严重程度、肺功能和哮喘相关生活质量）之间的关系。
使用典型相关分析对数据进行分析，这是一种多变量框架，允许在同一个模型中检查所有感兴趣的变量。
我们发现抑郁和焦虑症状与哮喘结果之间存在统计学显著关系（1-Λ=.372；P<0.001）。大的效应大小表明，在整个样本中，37.2%的方差在抑郁和焦虑症状与 4 项哮喘结果（特别是哮喘控制和哮喘相关生活质量）之间共享。与男孩相比，在女孩（而非男孩）中，哮喘控制（通过哮喘控制测试衡量）是哮喘结果的更强贡献因素。
这些结果表明，精神症状，尤其是焦虑，与较差的哮喘相关生活质量以及女孩比男孩对哮喘控制的更负面感知有关（在生理肺功能方面没有观察到性别差异）。临床医生应考虑将有关精神症状的问题纳入常规哮喘管理中，并将患者教育重点放在男孩和女孩对其哮喘症状的感知的独特差异上。
