Cabrera Guerrero Silvia, Håkansson Kjell Erik Julius, Backer Vibeke, Ulrik Charlotte Suppli, Rastogi Deepa
Division of Pulmonary and Sleep Medicine, Children's National Health System, Washington, DC, USA.
Department of Respiratory Medicine, Copenhagen University Hospital - Hvidovre, Hvidovre, Denmark.
J Asthma Allergy. 2023 Aug 8;16:821-831. doi: 10.2147/JAA.S421169. eCollection 2023.
Paediatric asthma is associated with caregiver depression, which in turn is associated with poor asthma control. Although sociodemographic risk factors are associated with parental depression among children with asthma, the contribution of these factors to caregiver depression in free-to-access universal healthcare settings is unknown.
The association between childhood asthma and parental antidepressant use was investigated in a Danish nationwide cohort of children aged 2-17 years that redeemed inhaled corticosteroids in 2015. The odds of antidepressant use were estimated in comparison to control families that were matched 1:1 on the number of siblings, residence, income, and education.
Among the families of 28,595 children with actively treated asthma, 12% of mothers and 6.2% of fathers were on antidepressant therapy, compared to 9.3% and 5.3% in controls (p<0.001). Paediatric asthma was associated with increased odds of parental antidepressant use (OR 1.29 (1.23-1.35)), even after adjusting for parental asthma. Poor asthma control, but not higher asthma severity, was associated with higher odds of antidepressant use (1.43 (1.31-1.56)). Compared with the controls, families with two or more children with asthma had higher OR (1.42 (1.29-1.56)) than those with a single child (OR 1.27 (1.21-1.34)). Low socioeconomic status was associated with parental antidepressant use.
Caregiver depression in a Danish cohort is more prevalent among mothers than among fathers and is associated with poor asthma control in children. Antidepressant use among caregivers was associated with total family asthma burden and was independent of socioeconomic status.
儿童哮喘与照料者抑郁相关，而照料者抑郁又与哮喘控制不佳有关。尽管社会人口学风险因素与哮喘患儿父母的抑郁有关，但在免费的全民医疗环境中，这些因素对应照料者抑郁的影响尚不清楚。
在丹麦一个全国性队列中，对2015年使用吸入性糖皮质激素的2至17岁儿童进行研究，调查儿童哮喘与父母使用抗抑郁药之间的关联。与在兄弟姐妹数量、居住地点、收入和教育程度方面1:1匹配的对照家庭相比，估算使用抗抑郁药的几率。
在28595名接受积极治疗的哮喘儿童家庭中，12%的母亲和6.2%的父亲接受抗抑郁治疗，而对照组分别为9.3%和5.3%（p<0.001）。即使在对父母哮喘进行校正后，儿童哮喘仍与父母使用抗抑郁药几率增加相关（比值比1.29（1.23 - 1.35））。哮喘控制不佳而非哮喘严重程度较高，与使用抗抑郁药的几率较高相关（1.43（1.31 - 1.56））。与对照组相比，有两个或更多哮喘儿童的家庭的比值比（1.42（1.29 - 1.56））高于只有一个哮喘儿童的家庭（比值比1.27（1.21 - 1.34））。社会经济地位低与父母使用抗抑郁药有关。
丹麦队列中，照料者抑郁在母亲中比在父亲中更普遍，且与儿童哮喘控制不佳有关。照料者使用抗抑郁药与家庭哮喘总负担相关，且独立于社会经济地位。
