Original Articles

Severity and persistence of asthma and mental health: a birth cohort study

R. D. Goodwin^a1a2 c1, M. Robinson^a3, P. D. Sly^a4, I. W. McKeague^a5, E. S. Susser^a2a6, S. R. Zubrick^a3, F. J. Stanley^a3 and E. Mattes^a3

^a1 Department of Psychology, Queens College, City University of New York, Flushing, New York, USA

^a2 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

^a3 Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Crawley, WA, Australia

^a4 Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Australia

^a5 Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA

^a6 Department of Psychiatry, Columbia University and New York State Psychiatric Institute, NY, USA

Background The goal of the current study was to investigate asthma and mental health among youth in the community, and to consider the role of asthma severity and persistence in this link.

Method Data were drawn from the Raine Study, a population-based birth cohort study in Western Australia. Logistic regression models and generalized estimating equations were used to examine the relationship between asthma at age 5 years and the range of internalizing and externalizing mental health problems at ages 5–17 years. Analyses were stratified by asthma severity and persistence, and adjusted for a range of potential confounders.

Results More severe and persistent asthma at age 5 was associated with significantly increased odds of affective, anxiety, somatic, oppositional defiant and conduct problems at ages 5–17. Mild asthma and remitted asthma were not associated with heightened vulnerability to mental disorders.

Conclusions Our results suggest that youth with symptomatic asthma are more likely to suffer from a wide range of mental health problems, and that the likelihood of mental health problems appears to increase as a function of asthma severity. Youth with poorly controlled and/or more severe and persistent asthma may be considered a vulnerable group who might benefit from mental health screening in clinical, school and community settings.

(Received December 15 2011)

(Revised June 27 2012)

(Accepted July 05 2012)

(Online publication August 29 2012)

Key words

• ADHD;
• anxiety;
• asthma;
• depression;
• youth

Correspondence

^c1 Address for correspondence: R. D. Goodwin, PhD, MPH, 722 West 168th Street, Room 1505, New York, NY 10032, USA. (Email: rdg66@columbia.edu)