School of Public Health, The University of Queensland, Herston, Queensland, Australia.
Center for Food Allergy and Asthma Research, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Pediatr Allergy Immunol. 2023 Mar;34(3):e13941. doi: 10.1111/pai.13941.
Evidence has suggested a bidirectional association between both the effects and onset of asthma and anxiety. The direction of this association in children and adolescents is less clear. The study evaluates whether anxiety in children is associated with the development of later asthma or, by contrast, whether asthma in children precedes anxiety.
Parental reports from 9369 children at two age points (4-5 and 14-15 years old) and from baby (B) (recruited at birth in 2004) and kindergarten (K) (recruited at 4-5 years of age in 2004) cohorts of the Longitudinal Study of Australian Children (LSAC) were analyzed. Asthma cases were defined as reports of doctor-diagnosed asthma and the use of asthma medication or/and wheezing. Scores of the Strengths and Difficulties Questionnaire (SDQ) defined anxiety.
We found a unidirectional association between asthma in children aged 4-5 years and future anxiety development in weighted generalized linear adjusted models (B cohort OR (CI 95%) = 1.54 (1.14-2.08); K cohort OR (CI 95%) = 1.87 (1.40-2.49)). Children with asthma (no anxiety at 4 years) had a higher prevalence of anxiety in adolescence compared with nonasthmatics (B cohort = 26.8% vs 17.6%: K cohort = 27.7% vs 14.3%). Anxiety in childhood was not associated with the development of asthma from 6 years old to adolescence.
Australian children with asthma have a greater risk of developing anxiety from 6 to 15 years old. This suggests that early multidisciplinary intervention may be required to support children with asthma to either prevent the increased risk of anxiety and/or promote optimal anxiety management.
有证据表明，哮喘和焦虑的影响和发病之间存在双向关联。儿童和青少年中这种关联的方向尚不清楚。本研究评估儿童的焦虑是否与随后发生哮喘有关，或者相反，儿童哮喘是否先于焦虑。
对来自澳大利亚儿童纵向研究（LSAC）的两个年龄组（4-5 岁和 14-15 岁）和婴儿（B）组（2004 年出生时招募）和幼儿园（K）组（2004 年 4-5 岁时招募）的 9369 名儿童的父母报告进行了分析。哮喘病例定义为医生诊断的哮喘报告以及使用哮喘药物和/或喘息。使用困难问卷（SDQ）的分数定义焦虑。
在加权广义线性调整模型中，我们发现 4-5 岁儿童的哮喘与未来焦虑发展之间存在单向关联（B 队列 OR（95%CI）=1.54（1.14-2.08）；K 队列 OR（95%CI）=1.87（1.40-2.49））。与非哮喘儿童相比，患有哮喘（4 岁时无焦虑）的儿童在青春期焦虑的患病率更高（B 队列为 26.8%比 17.6%：K 队列为 27.7%比 14.3%）。儿童时期的焦虑与从 6 岁到青春期的哮喘发展无关。
澳大利亚患有哮喘的儿童在 6 至 15 岁时患焦虑症的风险增加。这表明可能需要早期进行多学科干预，以支持哮喘儿童预防焦虑风险增加和/或促进最佳焦虑管理。
