Childhood Adversity, Early-Onset Depressive/Anxiety Disorders, and Adult-Onset Asthma

Department of Psychological Medicine, School of Medicine and Health Sciences, Otago University, Wellington, Wellington South, New Zealand.
Psychosomatic Medicine (Impact Factor: 3.47). 10/2008; 70(9):1035-43. DOI: 10.1097/PSY.0b013e318187a2fb
Source: PubMed


To investigate a) whether childhood adversity predicts adult-onset asthma; b) whether early-onset depressive/anxiety disorders predict adult-onset asthma; and c) whether childhood adversity and early-onset depressive/anxiety disorders predict adult-onset asthma independently of each other. Previous research has suggested, but not established, that childhood adversity may predict adult-onset asthma and, moreover, that the association between mental disorders and asthma may be a function of shared risk factors, such as childhood adversity.
Ten cross-sectional population surveys of household-residing adults (>18 years, n = 18,303) assessed mental disorders with the Composite International Diagnostic Interview (CIDI 3.0) as part of the World Mental Health surveys. Assessment of a range of childhood family adversities was included. Asthma was ascertained by self-report of lifetime diagnosis and age of diagnosis. Survival analyses calculated hazard ratios (HRs) for risk of adult-onset (>age 20 years) asthma as a function of number and type of childhood adversities and early-onset (<age 21 years) depressive and anxiety disorders, adjusting for current age, sex, country, education, and current smoking.
Childhood adversities predicted adult-onset asthma with risk increasing with the number of adversities experienced (HRs = 1.49-1.71). Early-onset depressive and anxiety disorders also predicted adult-onset asthma (HRs = 1.67-2.11). Childhood adversities and early-onset depressive and anxiety disorders both predicted adult-onset asthma after mutual adjustment (HRs = 1.43-1.91).
Childhood adversities and early-onset depressive/anxiety disorders independently predict adult-onset asthma, suggesting that the mental disorder-asthma relationship is not a function of a shared background of childhood adversity.

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    • "Those respondents who reported that the experience occurred before the age of 18 and met the criteria specified for a given adversity were coded as having experienced childhood family adversity. Assessment of the adversities is detailed in prior publications [24] [25]. "
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    ABSTRACT: Recent research demonstrating concurrent associations between mental disorders and peptic ulcers has renewed interest in links between psychological factors and ulcers. However, little is known about associations between temporally prior mental disorders and subsequent ulcer onset. Nor has the potentially confounding role of childhood adversities been explored. The objective of this study was to examine associations between a wide range of temporally prior DSM-IV mental disorders and subsequent onset of ulcer, without and with adjustment for mental disorder comorbidity and childhood adversities. Face-to-face household surveys conducted in 19 countries (n=52,095; person years=2,096,486). The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Peptic ulcer onset was assessed in the same interview by self-report of physician's diagnosis and year of diagnosis. Survival analyses estimated associations between first onset of mental disorders and subsequent ulcer onset. After comorbidity and sociodemographic adjustment, depression, social phobia, specific phobia, post-traumatic stress disorder, intermittent explosive disorder, alcohol and drug abuse disorders were significantly associated with ulcer onset (ORs 1.3-1.6). Increasing number of lifetime mental disorders was associated with ulcer onset in a dose-response fashion. These associations were only slightly attenuated by adjustment for childhood adversities. A wide range of mental disorders were linked with the self-report of subsequent peptic ulcer onset. These associations require confirmation in prospective designs, but are suggestive of a role for mental disorders in contributing to ulcer vulnerability, possibly through abnormalities in the physiological stress response associated with mental disorders.
    Journal of psychosomatic research 08/2013; 75(2):121-7. DOI:10.1016/j.jpsychores.2013.04.007 · 2.74 Impact Factor
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    • "Similar to stress and other psychological factors, it is now well established the asthma is associated with depression (Ortega et al, 2002; Ortega et al, 2004), although the exact etiology is not established. For example, there is recent evidence that asthma and depression may be linked by early childhood adversity (Scott et al, 2008). It is well established that depressed persons have more suicidal ideation and behavior than non-depressed persons. "
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    ABSTRACT: There is growing evidence of a positive association between asthma and suicidal ideation and behavior in the general community, although information on this potential association is scarce among older children and adolescents and Puerto Ricans, groups at risk for both conditions. Data came from wave 3 of the Boricua Youth Study, a longitudinal study of youth in the Bronx and San Juan conducted from 2000 to 2004. Logistic regressions for correlated data (Generalized Estimating Equation) were conducted, with asthma predicting suicidal ideation and behavior among participants 11 years or older. After adjustment for survey design; age; sex; poverty; Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, mental disorders; cigarette smoking; and stressful life events, asthma was positively associated with suicidal ideation and behavior among the Puerto Rican older children and adolescents. Public health interventions targeting Puerto Rican older children and adolescents with asthma and future studies investigating potential biological and psychological mechanisms of association are warranted.
    The Journal of nervous and mental disease 07/2013; 201(7):587-91. DOI:10.1097/NMD.0b013e3182982ba4 · 1.69 Impact Factor
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    • "Asthma was found to be associated with psychological conditions such as stress, anxiety, and depression in observational studies of various sample populations [1] [2] [3] [4] [5] [6] [7] [8]. A meta-analysis was conducted by examining 15 publications of primarily cross-sectional, uncontrolled study designs over a total of 1,494 adults [9]. "
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    ABSTRACT: Background. Asthma and depression are important public-health concerns worldwide. While some epidemiologic studies have shown asthma and wheezing to be associated with depression and anxiety, the patterns are unclear at the multinational level due to the lack of cross-study comparability. Our study examined the associations of self-reported asthma diagnosis and current wheezing with self-reported depression diagnosis and 30-day anxiety using an international survey. Methods. Using the 2002 World Health Survey, a standardized international survey conducted by the WHO, we estimated the associations between diagnosed asthma and current wheezing with diagnosed depression and 30-day anxiety via multiple logistic regressions for 54 countries worldwide. Results. Diagnosed depression and 30-day anxiety were associated with diagnosed asthma in 65% and 40% of the countries, respectively. Diagnosed depression and 30-day anxiety were associated with current wheezing in 83% and 82% of the countries, respectively. Conclusions. The association between asthma and depression was generally seen at the global level. These results indicated the importance of addressing the asthma-depression comorbidity as public-health and clinical management priorities, in order to improve the overall health of the countries.
    Pulmonary Medicine 03/2013; 2013(3):929028. DOI:10.1155/2013/929028
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