Skip to main content

Advertisement

SpringerLink
Log in

Children and adolescents’ health-related quality of life in relation to eczema, asthma and hay fever: results from a population-based cross-sectional study

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

Several studies have looked at the relationship between childhood atopic disease and health-related quality of life (HRQoL), but existing research is limited by selected populations, small samples or lack to consider each of the three atopic conditions simultaneously.

Methods

Impact of 4-week and 12-month occurrences of the three conditions on HRQoL were analysed by the use of complex sample general linear models alone and adjusted for the other atopic conditions, sociodemographics and mental health in a population-based sample (n = 6,518) of children and adolescents aged 11–17.

Results

In univariate analyses, total HRQoL was significantly impacted by eczema and hay fever but not asthma with stronger effects for 4-week occurrence. In multivariate analyses, 12-month occurrence of hay fever and 4-week occurrence of eczema and hay fever significantly impacted on total HRQoL. Although most of the variance in HRQoL was explained by mental health, independent effects of the atopic conditions remained.

Conclusion

Atopic conditions impact HRQoL over and above mental health. When analysing the relationship between atopic conditions and HRQoL, it is important to consider more immediate versus less immediate effects of the conditions. Extent of impairment and the domains affected appear to vary when different time intervals are used.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

CAPI:

Computer-assisted personal interviews

HRQoL:

Health-related quality of life

KiGGS:

Health Interview and Examination Survey for Children and Adolescents

KINDL:

Kindliche Lebensqualität (quality of life in children)

SDQ:

Strengths and Difficulties Questionnaire

GLM:

General linear model

References

  1. Johansson, S. G., Bieber, T., Dahl, R., Friedmann, P. S., Lanier, B. Q., Lockey, R. F., et al. (2004). Revised nomenclature for allergy for global use: Report of the nomenclature review committee of the world allergy organization, October 2003. Journal of Allergy and Clinical Immunology, 113(5), 832–836.

    Article  PubMed  CAS  Google Scholar 

  2. Simpson, C. R., & Sheikh, A. (2010). Trends in the epidemiology of asthma in England: A national study of 333, 294 patients. Journal of the Royal Society of Medicine, 103(3), 98–106.

    Article  PubMed  Google Scholar 

  3. James, A. L., Knuiman, M. W., Divitini, M. L., Hui, J., Hunter, M., Palmer, L. J., et al. (2010). Changes in the prevalence of asthma in adults since 1966: The Busselton health study. European Respiratory Journal, 35(2), 273–278.

    Article  PubMed  CAS  Google Scholar 

  4. Horii, K. A., Simon, S. D., Liu, D. Y., & Sharma, V. (2007). Atopic dermatitis in children in the United States, 1997–2004: Visit trends, patient and provider characteristics, and prescribing patterns. Pediatrics, 120(3), e527–e534.

    Article  PubMed  Google Scholar 

  5. Grize, L., Gassner, M., Wuthrich, B., Bringolf-Isler, B., Takken-Sahli, K., Sennhauser, F. H., et al. (2006). Trends in prevalence of asthma, allergic rhinitis and atopic dermatitis in 5–7-year old Swiss children from 1992 to 2001. Allergy, 61(5), 556–562.

    Article  PubMed  CAS  Google Scholar 

  6. Mortz, C. G., Lauritsen, J. M., Bindslev-Jensen, C., & Andersen, K. E. (2001). Prevalence of atopic dermatitis, asthma, allergic rhinitis, and hand and contact dermatitis in adolescents. The odense adolescence cohort study on atopic diseases and dermatitis. British Journal of Dermatology, 144(3), 523–532.

    Article  PubMed  CAS  Google Scholar 

  7. Bieber, T. (2010). Atopic dermatitis. Annals of Dermatology, 22(2), 125–137.

    Article  PubMed  CAS  Google Scholar 

  8. Bousquet, J., Jeffery, P. K., Busse, W. W., Johnson, M., & Vignola, A. M. (2000). Asthma. From bronchoconstriction to airways inflammation and remodeling. American Journal of Respiratory and Critical Care Medicine, 161(5), 1720–1745.

    PubMed  CAS  Google Scholar 

  9. Bousquet, J., Van Cauwenberge, P., & Khaltaev, N. (2001). Allergic rhinitis and its impact on asthma. Journal of Allergy and Clinical Immunology, 108(5 Suppl), S147–S334.

    Article  PubMed  CAS  Google Scholar 

  10. McNeill, G., Tagiyeva, N., Aucott, L., Russell, G., & Helms, P. J. (2009). Changes in the prevalence of asthma, eczema and hay fever in pre-pubertal children: A 40-year perspective. Paediatric and Perinatal Epidemiology, 23(6), 506–512.

    Article  PubMed  CAS  Google Scholar 

  11. Odhiambo, J. A., Williams, H. C., Clayton, T. O., Robertson, C. F., & Asher, M. I. (2009). Global variations in prevalence of eczema symptoms in children from ISAAC phase three. Journal of Allergy and Clinical Immunology, 124(6), 1251–1258, e1223.

    Google Scholar 

  12. Blaiss, M. S. (2007). Allergic rhinoconjunctivitis: Burden of disease. Allergy and Asthma Proceedings, 28(4), 393–397.

    Article  PubMed  Google Scholar 

  13. Van Wonderen, K. E., Van Der Mark, L. B., Mohrs, J., Bindels, P. J., Van Aalderen, W. M., & Ter Riet, G. (2010). Different definitions in childhood asthma: How dependable is the dependent variable? European Respiratory Journal, 36(1), 48–56.

    Article  PubMed  Google Scholar 

  14. Rodriguez, E., Baurecht, H., Herberich, E., Wagenpfeil, S., Brown, S. J., Cordell, H. J., et al. (2009). Meta-analysis of filaggrin polymorphisms in eczema and asthma: Robust risk factors in atopic disease. Journal of Allergy and Clinical Immunology, 123(6), 1361–1370, e1367.

    Google Scholar 

  15. van den Oord, R. A., & Sheikh, A. (2009). Filaggrin gene defects and risk of developing allergic sensitisation and allergic disorders: Systematic review and meta-analysis. British Medical Journal, 339, b2433.

    Article  PubMed  Google Scholar 

  16. Williams, H. C., & Grindlay, D. J. (2010). What’s new in atopic eczema? An analysis of systematic reviews published in 2007 and 2008. Part 1. Definitions, causes and consequences of eczema. Clinical & Experimental Dermatology, 35(1), 12–15.

    Article  CAS  Google Scholar 

  17. Dean, B. B., Calimlim, B. M., Kindermann, S. L., Khandker, R. K., & Tinkelman, D. (2009). The impact of uncontrolled asthma on absenteeism and health-related quality of life. Journal of Asthma, 46(9), 861–866.

    Article  PubMed  Google Scholar 

  18. Holm, E. A., Wulf, H. C., Stegmann, H., & Jemec, G. B. (2006). Life quality assessment among patients with atopic eczema. British Journal of Dermatology, 154(4), 719–725.

    Article  PubMed  CAS  Google Scholar 

  19. Meltzer, E. O. (2001). Quality of life in adults and children with allergic rhinitis. Journal of Allergy and Clinical Immunology, 108(1 Suppl), S45–S53.

    Article  PubMed  CAS  Google Scholar 

  20. Meltzer, E. O., Blaiss, M. S., Derebery, M. J., Mahr, T. A., Gordon, B. R., Sheth, K. K., et al. (2009). Burden of allergic rhinitis: Results from the Pediatric Allergies in America survey. Journal of Allergy and Clinical Immunology, 124(3 Suppl), S43–S70.

    Article  PubMed  Google Scholar 

  21. Marklund, B., Ahlstedt, S., & Nordstrom, G. (2004). Health-related quality of life among adolescents with allergy-like conditions - with emphasis on food hypersensitivity. Health and Quality of Life Outcomes, 2, 65.

    Article  PubMed  Google Scholar 

  22. Chamlin, S. L. (2006). The psychosocial burden of childhood atopic dermatitis. Dermatologic Therapy, 19(2), 104–107.

    Article  PubMed  Google Scholar 

  23. Chamlin, S. L., Frieden, I. J., Williams, M. L., & Chren, M. M. (2004). Effects of atopic dermatitis on young American children and their families. Pediatrics, 114(3), 607–611.

    Article  PubMed  Google Scholar 

  24. Ganemo, A., Svensson, A., Lindberg, M., & Wahlgren, C. F. (2007). Quality of life in Swedish children with eczema. Acta Dermato-Venereologica, 87(4), 345–349.

    Article  PubMed  Google Scholar 

  25. O’Connell, E. J. (2004). The burden of atopy and asthma in children. Allergy, 59(Suppl 78), 7–11.

    Google Scholar 

  26. Meads, D. M., McKenna, S. P., & Kahler, K. (2005). The quality of life of parents of children with atopic dermatitis: Interpretation of PIQoL-AD scores. Quality of Life Research, 14(10), 2235–2245.

    Article  PubMed  CAS  Google Scholar 

  27. Annett, R. D., Turner, C., Brody, J. L., Sedillo, D., & Dalen, J. (2010). Using structural equation modeling to understand child and parent perceptions of asthma quality of life. Journal of Pediatric and Psychology, 35, 870–882.

    Article  Google Scholar 

  28. Both, H., Essink-Bot, M.-L., Busschbach, J., & Nijsten, T. (2007). Critical review of generic and dermatology-specific health-related quality of life instruments. Journal of Investigative Dermatology, 127(12), 2726–2739.

    Article  PubMed  CAS  Google Scholar 

  29. Ware, J. E., Jr., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473–483.

    Article  PubMed  Google Scholar 

  30. Bullinger, M., & Kirchberger, I. (1998). SF-36-Fragebogen zum Gesundheitszustand—Handanweisung, vol. 00. Göttingen: Hogrefe.

    Google Scholar 

  31. Landgraf, J., Abetz, L., & Ware, J. (1999). The CHQ user’s manual. Boston, MA: Health Act.

    Google Scholar 

  32. Ravens-Sieberer, U., & Bullinger, M. (1998). Assessing health-related quality of life in chronically ill children with the German KINDL: First psychometric and content analytical results. Quality of Life Research, 7(5), 399–407.

    Article  PubMed  CAS  Google Scholar 

  33. Lewis-Jones, M. S., & Finlay, A. Y. (1995). The children’s dermatology life quality index (CDLQI): Initial validation and practical use. British Journal of Dermatology, 132(6), 942–949.

    Article  PubMed  CAS  Google Scholar 

  34. Lewis-Jones, M. S., Finlay, A. Y., & Dykes, P. J. (2001). The infants’ dermatitis quality of life index. British Journal of Dermatology, 144(1), 104–110.

    Article  PubMed  CAS  Google Scholar 

  35. Juniper, E. F., Guyatt, G. H., Feeny, D. H., Ferrie, P. J., Griffith, L. E., & Townsend, M. (1996). Measuring quality of life in children with asthma. Quality of Life Research, 5(1), 35–46.

    Article  PubMed  CAS  Google Scholar 

  36. Juniper, E. F., Guyatt, G. H., & Dolovich, J. (1994). Assessment of quality of life in adolescents with allergic rhinoconjunctivitis: Development and testing of a questionnaire for clinical trials. Journal of Allergy and Clinical Immunology, 93(2), 413–423.

    Article  PubMed  CAS  Google Scholar 

  37. Ravens-Sieberer, U., Ellert, U., & Erhart, M. (2007). Health-related quality of life of children and adolescents in Germany. Norm data from the German health interview and examination survey (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 50(5–6), 810–818.

    PubMed  CAS  Google Scholar 

  38. Schmitt, J., Romanos, M., Pfennig, A., Leopold, K., & Meurer, M. (2009). Psychiatric comorbidity in adult eczema. British Journal of Dermatology, 161(4), 878–883.

    Article  PubMed  CAS  Google Scholar 

  39. Wamboldt, M. Z., Hewitt, J. K., Schmitz, S., Wamboldt, F. S., Räsänen, M., Koskenvuo, M., et al. (2000). Familial association between allergic disorders and depression in adult Finnish twins. American Journal of Medical Genetics, 96(2), 146–153.

    Article  PubMed  CAS  Google Scholar 

  40. Hasler, G., Gergen, P. J., Kleinbaum, D. G., Ajdacic, V., Gamma, A., Eich, D., et al. (2005). Asthma and panic in young adults: A 20-year prospective community study. American Journal of Respiratory and Critical Care Medicine, 171(11), 1224–1230.

    Article  PubMed  Google Scholar 

  41. Goodwin, R. D. (2002). Self-reported hay fever and panic attacks in the community. Annals of Allergy, Asthma & Immunology, 88(6), 556–559.

    Article  Google Scholar 

  42. Lien, L., Green, K., Thoresen, M., & Bjertness, E. (2010). Atopic conditions and mental health problems: A 3-year follow-up study. European Child and Adolescent Psychiatry, 19(9), 705–713.

    Article  PubMed  Google Scholar 

  43. Koch-Institut, R. (2008). Public-use-file KiGGS. Kinder und Jugendgesundheitssurvey 2003–2006. Berlin.

  44. Kurth, B. M., Kamtsiuris, P., Holling, H., Schlaud, M., Dolle, R., Ellert, U., et al. (2008). The challenge of comprehensively mapping children’s health in a nation-wide health survey: Design of the German KiGGS-study. BMC Public Health, 8, 196.

    Article  PubMed  Google Scholar 

  45. Kamtsiuris, P., Lange, M., & Schaffrath Rosario, A. (2007). Der Kinder- und Jugendgesundheitssurvey (KiGGS): Stichprobendesign, response und nonresponse-analyse [The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): Sample design, response and nonresponse analysis]. Bundesgesundheitsblatt—Gesundheitsforschung—Gesundheitsschutz, 50(5), 547–556.

    Article  PubMed  CAS  Google Scholar 

  46. Schlaud, M., Atzpodien, K., & Thierfelder, W. (2007). Allergic diseases. Results from the German health interview and examination survey for children and adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 50(5–6), 701–710.

    PubMed  CAS  Google Scholar 

  47. Bullinger, M., Brutt, A. L., Erhart, M., & Ravens-Sieberer, U. (2008). Psychometric properties of the KINDL-R questionnaire: Results of the BELLA study. European Child and Adolescent Psychiatry, 17(Suppl 1), 125–132.

    Google Scholar 

  48. Erhart, M., Ellert, U., Kurth, B. M., & Ravens-Sieberer, U. (2009). Measuring adolescents’ HRQoL via self reports and parent proxy reports: An evaluation of the psychometric properties of both versions of the KINDL-R instrument. Health and Quality of Life Outcomes, 7, 77.

    Article  PubMed  Google Scholar 

  49. Winkler, J., & Stolzenberg, H. (1999). Der Sozialschichtindex im Bundes-Gesundheitssurvey. Gesundheitswesen, 61(Sonderheft 2), 178–183.

  50. Goodman, R., Meltzer, H., & Bailey, V. (1998). The strengths and difficulties questionnaire: A pilot study on the validity of the self-report version. European Child and Adolescent Psychiatry, 7(3), 125–130.

    Article  PubMed  CAS  Google Scholar 

  51. Kromeyer-Hauschild, K., & Zellner, K. (2007). Trends in overweight and obesity and changes in the distribution of body mass index in schoolchildren of Jena, East Germany. European Journal of Clinical Nutrition, 61(3), 404–411.

    Article  PubMed  CAS  Google Scholar 

  52. Evans, S., Banerjee, S., Leese, M., & Huxley, P. (2007). The impact of mental illness on quality of life: A comparison of severe mental illness, common mental disorder and healthy population samples. Quality of Life Research, 16(1), 17–29.

    Article  PubMed  Google Scholar 

  53. Noal, R. B., Menezes, A. M., Macedo, S. E., & Dumith, S. C. (2010). Childhood body mass index and risk of asthma in adolescence: A systematic review. Obesity Reviews, 12(2), 93–104.

    Article  Google Scholar 

  54. Schmitt, J., Apfelbacher, C., Chen, C. M., Romanos, M., Sausenthaler, S., Koletzko, S., et al. (2010). Infant-onset eczema in relation to mental health problems at age 10 years: Results from a prospective birth cohort study (German Infant Nutrition Intervention plus). Journal of Allergy and Clinical Immunology, 125(2), 404–410.

    Article  PubMed  Google Scholar 

  55. Williams, H. C. (2000). Epidemiology of atopic dermatitis. Clinical & Experimental Dermatology, 25(7), 522–529.

    Article  CAS  Google Scholar 

  56. Muthén, L. K., & Muthén, B. O. (1998-2007). Mplus user’s guide. Fifth Edition. Los Angeles, CA: Muthén & Muthén.

  57. Mozaffari, H., Pourpak, Z., Pourseyed, S., Farhoodi, A., Aghamohammadi, A., Movahadi, M., et al. (2007). Quality of life in atopic dermatitis patients. Journal of Microbiology, Immunology and Infection, 40(3), 260–264.

    Google Scholar 

  58. Beattie, P. E., & Lewis-Jones, M. S. (2006). A comparative study of impairment of quality of life in children with skin disease and children with other chronic childhood diseases. British Journal of Dermatology, 155(1), 145–151.

    Article  PubMed  CAS  Google Scholar 

  59. Meltzer, E. O., Nathan, R. A., Seiner, J. C., & Storms, W. (1997). Quality of life and rhinitic symptoms: Results of a nationwide survey with the SF-36 and RQLQ questionnaires. Journal of Allergy and Clinical Immunology, 99(6, Part 2), S815–S819.

    Google Scholar 

  60. Ben-Gashir, M. A., Seed, P. T., & Hay, R. J. (2002). Are quality of family life and disease severity related in childhood atopic dermatitis? Journal of the European Academy of Dermatology and Venereology, 16(5), 455–462.

    Article  PubMed  CAS  Google Scholar 

  61. Fortin, M., Bravo, G., Hudon, C., Lapointe, L., Almirall, J., Dubois, M. F., et al. (2006). Relationship between multimorbidity and health-related quality of life of patients in primary care. Quality of Life Research, 15(1), 83–91.

    Article  PubMed  Google Scholar 

  62. Michel, G., Bisegger, C., Fuhr, D. C., & Abel, T. (2009). Age and gender differences in health-related quality of life of children and adolescents in Europe: A multilevel analysis. Quality of Life Research, 18(9), 1147–1157.

    Article  PubMed  Google Scholar 

  63. Schmitt, J., Romanos, M., Schmitt, N. M., Meurer, M., & Kirch, W. (2009). Atopic eczema and attention-deficit/hyperactivity disorder in a population-based sample of children and adolescents. JAMA, 301(7), 724–726.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We are indebted to the Robert-Koch-Institut, Berlin, for making the data available as a public-use file. We thank all the children/adolescents and their parents for the time and efforts they dedicated to taking part in this study.

Author information

Authors and Affiliations

  1. Department of Clinical Social Medicine, Occupational and Environmental Dermatology and Health Services Research, University Hospital Heidelberg, University of Heidelberg, Thibautstrasse 3, 69115, Heidelberg, Germany

    Uwe Matterne, Thomas L. Diepgen & Christian Apfelbacher

  2. Department of Dermatology, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany

    Jochen Schmitt

  3. Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany

    Christian Apfelbacher

Authors
  1. Uwe Matterne
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jochen Schmitt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thomas L. Diepgen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christian Apfelbacher
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Uwe Matterne.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Matterne, U., Schmitt, J., Diepgen, T.L. et al. Children and adolescents’ health-related quality of life in relation to eczema, asthma and hay fever: results from a population-based cross-sectional study. Qual Life Res 20, 1295–1305 (2011). https://doi.org/10.1007/s11136-011-9868-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-011-9868-9

Keywords

Search

Navigation