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Psychiatric Morbidity and Behavioral Problems in Children and Adolescents with Bronchial Asthma

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objectives

Psychiatric morbidity and behavioral problems are quite common in children and adolescents with bronchial asthma, yet they remain underexplored and often ignored in clinical settings. This can impact the child’s overall quality of life. There seems to be a dearth of Indian literature and so the current study was planned to assess psychological impact of asthma on the pediatric population.

Methods

Thirty children and adolescents, attending the Pediatric Chest Clinic at a tertiary care hospital in North India in the age group of 8–15 y having moderate to severe asthma formed the study group and matched healthy controls formed the other group. Sociodemographic and clinical details were obtained. Mini International Neuropsychiatric Interview (M.I.N.I. KID) and Child Behavior Checklist (CBCL) were applied.

Results

Irregular attendance at school was reported by 23.33% of the participants with asthma. About 17% of the thirty study-participants were diagnosed with specific phobia, 10% with conduct disorder, and 7% with attention deficit hyperactivity disorder (ADHD). Participants in the study group had significantly more behavioral problems in the syndrome domain anxious/depressed and attention problems. Total CBCL scores were significantly higher in the study group as compared to the control group (t = 3.816, p = 0.0003), indicating the presence of more behavioral problems in pediatric population with bronchial asthma.

Conclusion

Children and adolescents with bronchial asthma have co-morbid psychiatric morbidities and behavioral problems.

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References

  1. Opolski M, Wilson I. Asthma and depression: a pragmatic review of the literature and recommendations for future research. Clin Pract Epidemiol Ment Health. 2005;1:18.

    Article  Google Scholar 

  2. Nakagome K, Nagata M. Pathogenesis of airway inflammation in bronchial asthma. Auris Nasus Larynx. 2011;38:555–63.

    Article  Google Scholar 

  3. Van Lieshout RJ, Macqueen G. Psychological factors in asthma. Allergy Asthma Clin Immunol. 2008;4:12–28.

    Article  Google Scholar 

  4. Torpy JM, Campbell A, Glass RM. Chronic diseases of children. JAMA. 2010;303:682.

    Article  CAS  Google Scholar 

  5. Most Recent National Asthma Data | CDC. [online] Available at: https://www.cdc.gov/asthma/most_recent_national_asthma_data.htm. Accessed 10 Dec. 2019.

  6. Bender B, Zhang L. Negative affect, medication adherence, and asthma control in children. J Allergy Clin Immunol. 2008;122:490–5.

    Article  Google Scholar 

  7. Bitsko MJ, Everhart RS, Rubin BK. The adolescent with asthma. Paediatr Respir Rev. 2014;15:146–53.

    PubMed  Google Scholar 

  8. Blackman JA, Gurka MJ. Developmental and behavioral comorbidities of asthma in children. J Dev Behav Pediatr. 2007;28:92–9.

    Article  Google Scholar 

  9. Bussing R, Halfon N, Benjamin B, Wells KB. Prevalence of behavior problems in US children with asthma. Arch Pediatr Adolesc Med. 1995;149:565–72.

    Article  CAS  Google Scholar 

  10. Sawant NS, Bhargava J, Deshmukh CT. Behavioural problems and parental over-protectiveness in children with asthma. J Nepal Paediatr Soc. 2017;36:232.

    Article  Google Scholar 

  11. Lu Y, Mak K-K, van Bever HPS, Ng TP, Mak A, Ho RC-M. Prevalence of anxiety and depressive symptoms in adolescents with asthma: a meta-analysis and meta-regression. Pediatr Allergy Immunol. 2012;23:707–15.

    Article  Google Scholar 

  12. Katon W, Lozano P, Russo J, McCauley E, Richardson L, Bush T. The prevalence of DSM-IV anxiety and depressive disorders in youth with asthma compared to controls. J Adolesc Health. 2007;41:455–63.

    Article  Google Scholar 

  13. Dudeney J, Sharpe L, Jaffe A, Jones EB, Hunt C. Anxiety in youth with asthma: a meta-analysis. Pediatr Pulmonol. 2017;52:1121–9.

    Article  Google Scholar 

  14. Bennett S, Shafran R, Coughtrey A, Walker S, Heyman I. Psychological interventions for mental health disorders in children with chronic physical illness: a systematic review. Arch Dis Child. 2015;100:308–16.

    Article  Google Scholar 

  15. Everhart RS, Fiese BH. Asthma severity and child quality of life in pediatric asthma: a systematic review. Patient Educ Couns. 2009;75:162–8.

    Article  Google Scholar 

  16. Global Initiative for Asthma [Internet]. Glob. Initiat. Asthma – GINA. Available at: http://ginasthma.org/. Accessed 26 Nov 2017.

  17. Malin AJ. Manual for Malin’s Intelligence Scale for Indian Children (MISIC). Lucknow: Indian Psychol Corp; 1969.

    Google Scholar 

  18. Sheehan D, Harnett-Sheehan K, Shytle R, et al. The mini-international neuropsychiatric interview for children and adolescents (MINI-KID): validity and reliability. J Clin Psychiatry. 2010;71:313–26.

    Article  Google Scholar 

  19. Achenbach TM, Rescorla LA. Manual for the ASEBA School Age Forms & Profiles: An Integrated System of Multi-informant Assessment. Burlington: University of Vermont, Research Center for Children; 2001.

  20. Singh M, Mathew JL, Malhi P, Naidu AN, Kumar L. Evaluation of quality of life in indian children with bronchial asthma using a disease-specific and locally appropriate questionnaire. Acta Paediatr. 2004;93:554–5.

    Article  CAS  Google Scholar 

  21. Zaky EA, Shaheen MA, Amr NH, El Said SMM. Psychosocial profile and quality of life in children with bronchial asthma; A comparative study of self reports and parent proxy reports of PedsQl™ inventory. Indian J Appl Res. 2015;5:33–39.

  22. Mogensen N, Larsson H, Lundholm C, Almqvist C. Association between childhood asthma and ADHD symptoms in adolescence – a prospective population-based twin study. Allergy. 2011;66:1224–30.

    Article  CAS  Google Scholar 

  23. Shyu C-S, Lin H-K, Lin C-H, Fu L-S. Prevalence of attention-deficit/hyperactivity disorder in patients with pediatric allergic disorders: a nationwide, population-based study. J Microbiol Immunol Infect. 2012;45:237–42.

    Article  Google Scholar 

  24. Arif A. The association between symptomatic asthma and neurobehavioral comorbidities among children. J Asthma. 2010;47:792–6.

    Article  Google Scholar 

  25. Desai T, Periasamy M, Nguyen D-T, Giri A, Mondal A, Madaan V. Study of variables affecting attention-deficit hyperactivity disorder (ADHD) and asthma comorbidity. J Am Acad Child Adolesc Psychiatry. 2017;56:S279.

    Article  Google Scholar 

  26. Grizenko N, Osmanlliu E, Fortier M-È, Joober R. Increased risk of asthma in children with ADHD: Role of prematurity and maternal stress during pregnancy. J Can Acad Child Adolesc Psychiatry. 2015;24:109.

    PubMed  PubMed Central  Google Scholar 

  27. Letitre SL, de Groot EP, Draaisma E, Brand PL. Anxiety, depression and self-esteem in children with well-controlled asthma: case–control study. Arch Dis Child. 2014;99:744–8.

    Article  Google Scholar 

  28. Wamboldt MZ, Fritz G, Mansell A, McQuaid EL, Klein RB. Relationship of asthma severity and psychological problems in children. J Am Acad Child Adolesc Psychiatry. 1998;37:943–50.

    Article  CAS  Google Scholar 

  29. Ortega AN, McQuaid EL, Canino G, Goodwin RD, Fritz GK. Comorbidity of asthma and anxiety and depression in Puerto Rican children. Psychosomatics. 2004;45:93–9.

    Article  Google Scholar 

  30. Al-khateeb AJ, AlKhateeb JM. Research on psychosocial aspects of asthma in the Arab world: a literature review. Multidiscip Respir Med. 2015;10.

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Authors and Affiliations

Authors

Contributions

PR: Conceptualization, methodology, investigation and data collection, writing-original draft, writing-review and editing; RS: Conceptualization, methodology, writing-review, supervision; BNP, RB and SKK: Conceptualization, methodology, writing-review. RS will act as guarantor for this paper.

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Correspondence to Rajesh Sagar.

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Rajhans, P., Sagar, R., Patra, B.N. et al. Psychiatric Morbidity and Behavioral Problems in Children and Adolescents with Bronchial Asthma. Indian J Pediatr 88, 968–973 (2021). https://doi.org/10.1007/s12098-021-03661-4

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  • DOI: https://doi.org/10.1007/s12098-021-03661-4

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