Jordi Alonso1, Peter de Jonge2, Carmen C W Lim3, Sergio Aguilar-Gaxiola4, Ronny Bruffaerts5, Jose Miguel Caldas-de-Almeida6, Zhaorui Liu7, Siobhan O'Neill8, Dan J Stein9, Maria Carmen Viana10, Ali Obaid Al-Hamzawi11, Matthias C Angermeyer12, Guilherme Borges13, Marius Ciutan14, Giovanni de Girolamo15, Fabian Fiestas16, Josep Maria Haro17, Chiyi Hu18, Ronald C Kessler19, Jean Pierre Lépine20, Daphna Levinson21, Yosikazu Nakamura22, Jose Posada-Villa23, Bogdan J Wojtyniak24, Kate M Scott3. 1. Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Pompeu Fabra University (UPF), Barcelona, Spain. Electronic address: jalonso@imim.es. 2. Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center, University of Groningen, Groningen, The Netherlands. 3. Department of Psychological Medicine, Otago University, Dunedin, New Zealand. 4. University of California, Davis, Center for Reducing Health Disparities, School of Medicine, Sacramento, CA, USA. 5. Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC - KUL), Leuven, Belgium. 6. Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciencias Medicas, Universidade Nova de Lisboa, Lisbon, Portugal. 7. Institute of Mental Health, Peking University, Beijing, PR China. 8. Bamford Centre for Mental Health and Well-Being, University of Ulster, Derry, Northern Ireland, UK. 9. University of Cape Town, Department of Psychiatry & Mental Health, Groote Schuur Hospital, Cape Town, South Africa. 10. Department of Social Medicine, Federal University of Espírito Santo (UFES), Vitória, Brazil. 11. Al-Qadisia University College of Medicine, Diwania, Iraq. 12. Center for Public Mental Health, Gosing am Wagram, Austria. 13. Division of Epidemiological and Psychosocial Research, National Institute of Psychiatry (Mexico) and Metropolitan Autonomous University, Mexico City, Mexico. 14. National School of Public Health and Professional Development, Bucharest, Romania. 15. IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy. 16. Evidence Generation for Public Health Research Unit, National Institute of Health, Lima, Peru. 17. Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; CIBER de Salud Mental (CIBERSAM), Spain; University of Barcelona, Barcelona, Spain. 18. Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Guangdong Province, PR China. 19. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. 20. Hôpital Saint-Louis Lariboisière Fernand Widal, INSERM U 705, CNRS UMR 8206, Paris, France. 21. Mental Health Services, Ministry of Health, Jerusalem, Israel. 22. Department of Public Health, Jichi Medical University, Yakushiji, Shimotsuke-shi, Tochigi-ken, Japan. 23. Colegio Mayor de Cundinamarca University, CALLE 28 No. 5B-02, Bogota, DC, Colombia. 24. Department-Centre of Monitoring and Analyses of Population Health, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland.
Abstract
BACKGROUND AND OBJECTIVES: Associations between asthma and anxiety and mood disorders are well established, but little is known about their temporal sequence. We examined associations between a wide range of DSM-IV mental disorders with adult onset of asthma and whether observed associations remain after mental comorbidity adjustments. METHODS: During face-to-face household surveys in community-dwelling adults (n = 52,095) of 19 countries, the WHO Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Asthma was assessed by self-report of physician's diagnosis together with age of onset. Survival analyses estimated associations between first onset of mental disorders and subsequent adult onset asthma, without and with comorbidity adjustment. RESULTS: 1860 adult onset (21 years+) asthma cases were identified, representing a total of 2,096,486 person-years of follow up. After adjustment for comorbid mental disorders several mental disorders were associated with subsequent adult asthma onset: bipolar (OR = 1.8; 95%CI 1.3-2.5), panic (OR = 1.4; 95%CI 1.0-2.0), generalized anxiety (OR = 1.3; 95%CI 1.1-1.7), specific phobia (OR = 1.3; 95%CI 1.1-1.6); post-traumatic stress (OR = 1.5; 95%CI 1.1-1.9); binge eating (OR = 1.8; 95%CI 1.2-2.9) and alcohol abuse (OR = 1.5; 95%CI 1.1-2.0). Mental comorbidity linearly increased the association with adult asthma. The association with subsequent asthma was stronger for mental disorders with an early onset (before age 21). CONCLUSIONS: A wide range of temporally prior mental disorders are significantly associated with subsequent onset of asthma in adulthood. The extent to which asthma can be avoided or improved among those with early mental disorders deserves study.
BACKGROUND AND OBJECTIVES: Associations between asthma and anxiety and mood disorders are well established, but little is known about their temporal sequence. We examined associations between a wide range of DSM-IV mental disorders with adult onset of asthma and whether observed associations remain after mental comorbidity adjustments. METHODS: During face-to-face household surveys in community-dwelling adults (n = 52,095) of 19 countries, the WHO Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Asthma was assessed by self-report of physician's diagnosis together with age of onset. Survival analyses estimated associations between first onset of mental disorders and subsequent adult onset asthma, without and with comorbidity adjustment. RESULTS: 1860 adult onset (21 years+) asthma cases were identified, representing a total of 2,096,486 person-years of follow up. After adjustment for comorbid mental disorders several mental disorders were associated with subsequent adult asthma onset: bipolar (OR = 1.8; 95%CI 1.3-2.5), panic (OR = 1.4; 95%CI 1.0-2.0), generalized anxiety (OR = 1.3; 95%CI 1.1-1.7), specific phobia (OR = 1.3; 95%CI 1.1-1.6); post-traumatic stress (OR = 1.5; 95%CI 1.1-1.9); binge eating (OR = 1.8; 95%CI 1.2-2.9) and alcohol abuse (OR = 1.5; 95%CI 1.1-2.0). Mental comorbidity linearly increased the association with adult asthma. The association with subsequent asthma was stronger for mental disorders with an early onset (before age 21). CONCLUSIONS: A wide range of temporally prior mental disorders are significantly associated with subsequent onset of asthma in adulthood. The extent to which asthma can be avoided or improved among those with early mental disorders deserves study.
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