Michelle Shankar1, Maria Fagnano2, Susan W Blaakman3, Hyekyun Rhee4, Jill S Halterman2. 1. Department of Pediatrics, Division of General Pediatrics (M Shankar, M Fagnano, SW Blaakman, and JS Halterman). Electronic address: michelle_shankar@urmc.rochester.edu. 2. Department of Pediatrics, Division of General Pediatrics (M Shankar, M Fagnano, SW Blaakman, and JS Halterman). 3. Department of Pediatrics, Division of General Pediatrics (M Shankar, M Fagnano, SW Blaakman, and JS Halterman); School of Nursing (SW Blaakman and H Rhee), University of Rochester, Rochester, NY. 4. School of Nursing (SW Blaakman and H Rhee), University of Rochester, Rochester, NY.
Abstract
OBJECTIVES: Asthma is the most common chronic disease of childhood in the United States, disproportionately affecting urban, poor, and minority children. Adolescents are at high risk for poor asthma outcomes and for depressive symptoms. The purpose of this study is to investigate associations between depressive symptoms and asthma-related clinical and functional outcomes among urban teens. METHODS: We used baseline data from a 3-arm randomized trial, School-Based Asthma Care for Teens, in Rochester, NY. We used the Center for Epidemiological Studies Depression Scale with a standard cutoff score of 16 to identify subjects at risk for clinical depression. We used structured in-home surveys and validated scales to assess clinical and functional outcomes and conducted bivariate and multivariate analyses to evaluate differences between groups. RESULTS: We identified 277 eligible teens (ages 12 to 16, 80% participation, 54% black, 34% Hispanic, 45% female, 84% on Medicaid). Overall, 28% reported depressive symptoms. Teens with depressive symptoms experienced greater asthma symptom severity and more acute health care utilization for asthma (all P < .001); however, there was no difference in preventive care use between groups. Teens with depressive symptoms also reported lower asthma-related quality of life (P < .001), less sleep (P < .001), and more limitation in mild (adjusted odds ratio [aOR], 2.60; 95% confidence interval [CI], 1.34-5.02) and moderate (aOR, 2.56; 95% CI, 1.41-4.61) activity and in gym (aOR, 2.33; 95% CI, 1.30-4.17). CONCLUSIONS: Depressive symptoms are prevalent among urban teens with asthma and are associated with worse asthma-related clinical outcomes, functional limitation, and quality of life. Providers should consider depression as a significant comorbidity that may impact multiple aspects of daily life for this population.
OBJECTIVES:Asthma is the most common chronic disease of childhood in the United States, disproportionately affecting urban, poor, and minority children. Adolescents are at high risk for poor asthma outcomes and for depressive symptoms. The purpose of this study is to investigate associations between depressive symptoms and asthma-related clinical and functional outcomes among urban teens. METHODS: We used baseline data from a 3-arm randomized trial, School-Based Asthma Care for Teens, in Rochester, NY. We used the Center for Epidemiological Studies Depression Scale with a standard cutoff score of 16 to identify subjects at risk for clinical depression. We used structured in-home surveys and validated scales to assess clinical and functional outcomes and conducted bivariate and multivariate analyses to evaluate differences between groups. RESULTS: We identified 277 eligible teens (ages 12 to 16, 80% participation, 54% black, 34% Hispanic, 45% female, 84% on Medicaid). Overall, 28% reported depressive symptoms. Teens with depressive symptoms experienced greater asthma symptom severity and more acute health care utilization for asthma (all P < .001); however, there was no difference in preventive care use between groups. Teens with depressive symptoms also reported lower asthma-related quality of life (P < .001), less sleep (P < .001), and more limitation in mild (adjusted odds ratio [aOR], 2.60; 95% confidence interval [CI], 1.34-5.02) and moderate (aOR, 2.56; 95% CI, 1.41-4.61) activity and in gym (aOR, 2.33; 95% CI, 1.30-4.17). CONCLUSIONS:Depressive symptoms are prevalent among urban teens with asthma and are associated with worse asthma-related clinical outcomes, functional limitation, and quality of life. Providers should consider depression as a significant comorbidity that may impact multiple aspects of daily life for this population.
Authors: Amy H Cheung; Rachel A Zuckerbrot; Peter S Jensen; Kareem Ghalib; Danielle Laraque; Ruth E K Stein Journal: Pediatrics Date: 2007-11 Impact factor: 7.124
Authors: Bronwyn K Brew; Emma Caffrey Osvald; Tong Gong; Anna M Hedman; Kirsten Holmberg; Henrik Larsson; Jonas F Ludvigsson; Mwenya Mubanga; Awad I Smew; Catarina Almqvist Journal: Clin Exp Allergy Date: 2022-07-28 Impact factor: 5.401