Disease severity, mental health, and quality of life of children and adolescents with asthma.

Asthma has been found related to a higher risk of psychological problems. Inconsistent results have been reported with respect to the quality of life of children with asthma. So there may be a complex relationship between asthma severity, quality of life, and psychological factors. The aim of this study was to examine the impact of asthma severity and emotional/behavioral problems on the quality of life of children and adolescents and on their need for support. Eighty-one children and adolescents (7-18 years old, 62 boys, 19 girls) with asthma participating in different intervention and rehabilitation programs completed the Ulm Inventory for Children, an instrument for assessing health-related quality of life. Psychological problems were rated using the Child Behavior Checklist (CBCL). Caregivers judged the patients' need for support due to asthma and due to psychosocial problems. Asthma severity was rated according to the GINA classification. The participants showed elevated caregiver-reported emotional and behavioral symptoms compared with the normative sample (mean CBCL total score T=63). Quality of life and the need for social support were significantly correlated with psychological symptoms. Asthma severity was neither correlated with quality of life nor with emotional/behavioral symptoms, but it was associated with the need for support due to asthma. Therefore, in our study, comorbid emotional and behavioral symptoms rather than disease severity predicted quality of life of children and adolescents with asthma. Treatment should be adjusted to the special needs of children with asthma and comorbid mental health problems. (c) 2006 Wiley-Liss, Inc.