Abstract
Background Child maltreatment is associated with asthma in adults. We examined whether lifetime major depressive disorder (MDD) or lifetime generalised anxiety disorder (GAD) mediate an association between child maltreatment and current asthma among 81 105 British adults in the UK Biobank who completed a mental health survey and had complete data on child maltreatment, GAD, MDD, asthma and relevant covariates but no diagnosis of chronic obstructive pulmonary disease.
Methods Child maltreatment was ascertained based on answers to the five questions in the Childhood Trauma Screener. Two mediators, lifetime MDD and GAD, were assessed based on the Composite International Diagnostic Interview Short Form. Current asthma was defined as physician-diagnosed asthma and wheeze or whistling in the chest in the previous year. Logistic regression was used for the multivariable analysis of child maltreatment and current asthma, and a mediation analysis was conducted to estimate the contributions of lifetime MDD and lifetime GAD to the child maltreatment–current asthma association.
Results In a multivariable analysis, any child maltreatment was associated with asthma (adjusted OR 1.22, 95% CI 1.15–1.28; p<0.01). In a mediation analysis adjusted for household income, educational attainment, smoking status, pack-years of smoking and other covariates, lifetime GAD and lifetime MDD explained 21.8% and 32.5%, respectively, of the child maltreatment–current asthma association. Similar results were obtained after excluding current smokers and former smokers with ≥10 pack-years of smoking from the mediation analysis.
Conclusion Our findings suggest that GAD and MDD mediate an association between child maltreatment and asthma in adults, independently of smoking.
Abstract
In British adults, child maltreatment is significantly associated with current asthma, and lifetime major depression disorder and lifetime generalised anxiety disorder mediate or explain part of this association, independently of smoking https://bit.ly/3MKyUcO
Footnotes
Author contributions: Y-Y. Han and J.C. Celedón participated in study design and implementation and data analysis. Q. Yan and W. Chen participated in data analysis. Y-Y. Han wrote the initial draft of the manuscript, which was reviewed by J.C. Celedón. All authors reviewed and approved the final version of the submitted manuscript.
Conflicts of interest: J.C. Celedón has received research materials from GSK and Merck (inhaled steroids) and Pharmavite (vitamin D and placebo capsules) to provide medications free of cost to participants in US National Institutes of Health-funded studies, unrelated to this work. The other authors have no conflicts of interest to declare.
Support statement: This study was conducted using the UK Biobank Resource under application number 43252. J.C. Celedón's contribution was supported by grants HL117191, HL152475 and MD011764 from the US National Institutes of Health (NIH). The contributions of Y-Y. Han, W. Chen and Q. Yan were supported by NIH grants MD011764 (Y-Y. Han), HL150431 (W. Chen) and HL138098 (Q. Yan). Funding information for this article has been deposited with the Crossref Funder Registry.
- Received December 14, 2021.
- Accepted March 5, 2022.
- Copyright ©The authors 2022. For reproduction rights and permissions contact permissions{at}ersnet.org