儿童期精神病理症状与青少年哮喘之间的前瞻性关联：GINIplus和LISA出生队列研究结果

Prospective association between psychopathological symptoms in childhood and asthma in adolescence: Results from the GINIplus and LISA birth cohort studies.

作者信息

Keim Pia-Marie, Greimel Ellen, Feldmann Lisa, Piechaczek Charlotte Elisabeth, Harris Carla P, Flexeder Claudia, Berdel Dietrich, von Berg Andrea, Koletzko Sibylle, Bauer Carl-Peter, Schikowski Tamara, Herberth Gunda, Heinrich Joachim, Schulte-Körne Gerd, Standl Marie

机构信息

Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, Germany.

German Center for Mental Health (DZPG), Partner Site Munich-Augsburg, Munich, Germany.

出版信息

Pediatr Allergy Immunol. 2025 Jul;36(7):e70151. doi: 10.1111/pai.70151.

DOI:10.1111/pai.70151

PMID:40702946

Abstract

BACKGROUND

Although there is a high co-occurrence of psychopathological symptoms and asthma, longitudinal studies considering asthma endotypes in childhood and adolescence are scarce. Therefore, this study examined the prospective association between psychopathology in childhood and current atopic and non-atopic asthma in adolescents, considering sex and puberty-related characteristics.

METHODS

The study includes 3584 participants (1790 females, 1794 males) from two German birth cohort studies, GINIplus and LISA. Psychopathological symptoms at age 10 (M = 10.06, SD = .22) were assessed by parent-reported Strengths and Difficulties Questionnaire (SDQ) and current asthma at age 15 (M = 15.07, SD = .30) was defined as a positive parent-reported medical diagnosis, wheezing, and/or medical treatment against asthma (at least two criteria). Atopic asthma was characterized as current asthma and a positive specific immunoglobulin E (IgE) test (≥0.35 kU/L), non-atopic asthma as current asthma without sensitization. Data were analyzed by logistic regression and multinomial regression models, controlling for potential covariates and confounders.

RESULTS

Psychopathological symptoms at age 10 were associated with asthma at age 15 (odds ratio (OR) = 1.69, 95% confidence interval (CI) = 1.04-2.92, p = .035). When examining the endotypes, this effect was replicated only for non-atopic asthma at age 15 (relative risk ratio (RRR) = 2.92, 95% CI = 1.13-7.60, p = .028), but not for atopic asthma (p = .381). Regarding the SDQ subscales, an association between peer problems at age 10 and atopic asthma at age 15 was revealed (RRR = 2.00, 95% CI 1.01-3.97, p = .048). Furthermore, significant interaction effects of puberty onset with psychopathological symptoms (p = .020), and particularly with peer problems (p = .029), were found on atopic asthma.

CONCLUSION

The findings highlight the importance of early recognition and treatment of psychopathological symptoms to prevent and reduce development, persistence and exacerbation of asthma endotypes, and point to the necessity for further research into hormonal mechanisms linking psychopathology with atopy.

摘要

背景

尽管精神病理症状与哮喘的共现率很高，但考虑儿童和青少年哮喘内型的纵向研究却很匮乏。因此，本研究考察了儿童期精神病理学与青少年期当前特应性和非特应性哮喘之间的前瞻性关联，并考虑了性别和青春期相关特征。

方法

该研究纳入了来自两项德国出生队列研究GINIplus和LISA的3584名参与者（1790名女性，1794名男性）。通过家长报告的优势与困难问卷（SDQ）评估10岁时（M = 10.06，标准差 = 0.22）的精神病理症状，15岁时（M = 15.07，标准差 = 0.30）的当前哮喘定义为家长报告的阳性医学诊断、喘息和/或针对哮喘的医学治疗（至少两项标准）。特应性哮喘的特征为当前哮喘且特异性免疫球蛋白E（IgE）检测呈阳性（≥0.35 kU/L），非特应性哮喘为当前哮喘且无致敏情况。数据通过逻辑回归和多项回归模型进行分析，控制潜在的协变量和混杂因素。

结果

10岁时的精神病理症状与15岁时的哮喘相关（优势比（OR） = 1.69，95%置信区间（CI） = 1.04 - 2.92，p = 0.035）。在考察内型时，这种效应仅在15岁时的非特应性哮喘中得到重现（相对风险比（RRR） = 2.92，95% CI = 1.13 - 7.60，p = 0.028），而在特应性哮喘中未得到重现（p = 0.381）。关于SDQ分量表，揭示了10岁时的同伴问题与15岁时的特应性哮喘之间的关联（RRR = 2.00，95% CI 1.01 - 3.97，p = 0.048）。此外，发现青春期开始与精神病理症状（p = 0.020），特别是与同伴问题（p = 0.029）之间在特应性哮喘上存在显著的交互作用。