Slattery MJ, Essex MJSpecificity in the association of anxiety, depression, and atopic disorders in a community sample of adolescents. J Psychiatr Res 45:788-795

Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Journal of Psychiatric Research (Impact Factor: 3.96). 11/2010; 45(6):788-95. DOI: 10.1016/j.jpsychires.2010.11.003
Source: PubMed


The specificity of relationships between anxiety and depressive symptoms, with each of the major atopic disorders of asthma, allergic rhinitis (AR), and atopic dermatitis (AD) was systematically investigated within a single study sample. Participants included 367 adolescents who participated in a community, longitudinal study investigating risk factors for the development of psychiatric and physical health problems. Mental health symptoms were assessed at 7, 9, 11, and 13 years of age. Lifetime history of atopic disorders was assessed by parent report at age 13. Analysis of variance was used to investigate the specificity of the associations between anxiety and depression, and each of the atopic disorders. Results indicated that anxiety was associated with a lifetime history of atopic disorders as a group. The association was significantly strengthened when controlling for depression and externalizing psychiatric symptoms. Among atopic disorders, "pure" anxiety was associated with asthma and AR, and having both asthma and AR strengthened the association compared to having either disorder alone. The association of "pure" anxiety with asthma and AR is consistent with existing data suggesting a relationship between anxiety and respiratory disorders. Having both asthma and AR appeared to confer an additive "dose effect" on the strength of the association. The lack of an association with depression suggests that other factors may contribute to the differential expression of anxiety and depression with atopic disorders. Findings demonstrate the importance of assessing the impact of co-morbid psychiatric symptoms and atopic disorders within individual studies to determine the specificity of underlying relationships between these conditions.

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Available from: Marilyn J Essex
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    • "Compared to eczema patients with normal levels of IgE, patients with higher levels (and thus a stronger allergic response) have been found to have increased levels of emotionality (Neuroticism) and worse stress coping mechanisms (Scheich et al., 1993), suggesting a psycho-biological mechanism that mediates the exhibited behaviours in eczema. An extensive review by Friedman and Kern (2014) indicates that factors such as depression and anxiety, both strongly associated with trait Neuroticism, play a part in many illnesses, including eczema (Ahmar and Kurban, 1976;Kim et al., 2006;Mizara et al., 2012;Schut et al., 2014;Slattery and Essex, 2011;Takahashi et al., 2013). Depression has been thought to only be a strong association of eczema when co-morbidity with anxiety is accounted for (Klokk et al., 2010), particularly with face eczema. "
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    • "Studies have examined the impact of adversity and mental health in childhood on subsequent allergic condition development . Epidemiological studies have shown an association between a history of asthma and anxiety disorders in children (Ortega et al. 2002 ) and adolescents (Slattery and Essex 2011 ). Prospective longitudinal research has shown a relationship between early life adversity or young adulthood anxiety disorder and the subsequent the development of asthma (Hasler et al. 2005 ; Scott et al. 2008 ) Research also suggests that maternal stress in early life (from birth until age 7) is associated to increased likelihood of childhood asthma (Kozyrskyj et al. 2008 ). "
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    • "A few studies are available on adolescents and these have found increased levels of psychological problems in those with eczema; but these studies have not controlled for socioeconomic factors (Saunes et al., 2007; Lien et al., 2010), or they have been performed in patients (Brenninkmeijer et al., 2009). Some publications show no association between eczema and increased anxiety/depression in adolescents (Magin et al., 2008; Slattery and Essex, 2011). "
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