The Role of Caregiver Major Depression in the Relationship Between Anxiety Disorders and Asthma Attacks in Island Puerto Rican Youth and Young Adults

Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY 10461, USA.
The Journal of nervous and mental disease (Impact Factor: 1.69). 05/2011; 199(5):313-8. DOI: 10.1097/NMD.0b013e3182174e84
Source: PubMed


The goal of this study was to assess whether the association between asthma attacks and anxiety disorders in youth/young adults is reduced after adjusting for the caregivers' psychiatric disorders. An island-wide probability sample of 641 households in Puerto Rico with youth/young adults between ages 10 and 25 years participated along with their caregivers. The Diagnostic Interview Schedule for Children and the Composite International Diagnostic Interview were conducted to assess anxiety and depressive disorders. Youth/young adults with an anxiety disorder were more likely to have a lifetime history of asthma attacks versus youth/young adults without an anxiety disorder. Caregivers of participants with asthma attacks were more likely to have major depression than did the caregivers of participants without asthma attacks. The association between asthma attacks and anxiety disorders in youth was no longer significant after adjustment for caregiver major depression. It is important to consider the role of caregiver depression in asthma-anxiety comorbidity in youth/young adults.

Download full-text


Available from: Alexander N Ortega
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Few population-based studies have assessed health outcomes and health care access and use among youth in the US Commonwealth of Puerto Rico. Data are from an island population-based sample of 337 youth, 10 to 17 years old, who participated in the Asthma, Depression, and Anxiety in Puerto Rican Youth Study. In-person interviews with youth and caregivers assessed self-rated physical and mental health, weight status, diagnosed health conditions, and health care access and use. Island Puerto Rican youth report slightly worse physical and mental health than mainland youth. Puerto Rican youth have high rates of asthma, headaches, and stomachaches. Also, 6 in 10 island youth use public health insurance, and 1 in 3 regularly receive care at the emergency department. Island Puerto Rican youth are at a health disadvantage compared with mainland youth. Public health research is needed to fully understand and combat health challenges among Puerto Rican youth.
    Full-text · Article · Apr 2012 · Clinical Pediatrics
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Asthma and mental health problems, such as depression, anxiety and behavior disorders, are common among youth and are significant sources of morbidity. There is a consistent association between asthma and anxiety/depression and a less consistent association between asthma and behavior disorders. Possible biological and psychological mechanisms may include inflammatory processes as well as the stress of having to live with a life-threatening condition. Future studies are warranted with longitudinal designs to establish temporality as well as measures of potential confounds. Biological and psychological measures would complement the longitudinal design to further establish causality. In addition, more information on the degree to which asthma and mental health have reciprocal influences on each other over time - and the mechanisms of these relationships - are needed in order to develop more effective intervention strategies to improve asthma control and mental health among those with both.
    Full-text · Article · Aug 2012 · Expert Review of Respiratory Medicine
  • [Show abstract] [Hide abstract]
    ABSTRACT: Puerto Rican children have the highest prevalence of asthma, but detailed descriptions of this population have been limited to the island of Puerto Rico and the northeastern United States. To describe the asthma characteristics of this urban Midwest cohort of Puerto Rican youth, focusing on medication behaviors, and to test whether their asthma outcomes are associated with their demographic and psychosocial variables. Data are from the baseline cohorts of a randomized controlled trial designed to improve medication adherence in Puerto Rican youth. Recruitment used a community-based participatory research approach. Data were collected in the home. Medications and medication technique were visually assessed, and adherence was determined using electronic medication monitors or counters. Data on asthma symptoms and morbidity, demographics, and psychosocial factors were collected. The recruitment of 101 participants (51 in elementary school and 50 in high school) was completed in 14 months. Despite overall high asthma severity and poor asthma control, 20% of participants had no reliever medicine in their home. Self-report of controller use was higher than actual controller medications visualized in the home. For those who had an inhaled corticosteroid medicine (only 45% of elementary school participants and 12% of high school participants), median adherence was 1.0 doses per day. Rates of depression and stress were very high among both caregivers and children. Puerto Rican youth in the Midwest bear a significant asthma burden in addition to other stressors, including depression. Visual inspection of medications and monitoring of adherence are critical for understanding asthma morbidity in this high-risk population.
    No preview · Article · Aug 2012 · Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology
Show more