The relationship between childhood asthma and mental health conditions

Abstract

Background: Mental health conditions are becoming more common and may have implications on childhood asthma.

Objectives: We examined the association between childhood asthma and mental health conditions and if asthma outcomes were worse among children with both asthma and a mental health condition.

Methods: In 2013 we completed a cross-sectional survey of urban and rural dwelling children (5-14 years, n=3,509) from Saskatchewan, Canada. Surveys were distributed through randomly selected schools for parental self-completion. Asthma was based on report of a previous doctor's diagnosis. Presence of a mental health condition was based on a report of doctor’s diagnosis of emotional, psychological, nervous difficulties, or ADD/ADHD. Allergy was based on a report of a respiratory allergy, hayfever, or eczema.

Results: Asthma prevalence was 19.1% while the prevalence of mental health conditions was 5.5%. Among those without asthma, 4.8% had a mental health condition while among those with asthma, the prevalence was 8.2% (p<0.001). Allergy affected mental health condition prevalence (allergic with asthma: 10.3%; not allergic with asthma: 3.4%; allergic without asthma: 7.0%; not allergic without asthma: 3.8%; p<0.001). Among those with asthma, if a mental health condition was present, they were more likely to experience nocturnal asthma symptoms (p<0.05) than if a mental health condition was not present. These associations remained after adjustment for confounding.

Conclusions: Children with asthma are more likely to experience a mental health condition than children without asthma and this may be related to worse outcomes (nocturnal asthma symptoms). The relationship appears to be driven by allergic disease.