Abstract
BackgroundMounting evidence implicates early life and prenatal immune disturbances in the etiology of severe mental illnesses. Asthma is a common illness associated with chronic aberrant immune responses. We aimed to determine if asthma in childhood and parents is associated with bipolar and schizophrenia spectrum disorders.MethodsA cohort study including all children born in Sweden 1973–1995 (N > 2 million) assessing associations between childhood hospitalization for asthma, parental asthma during and pre-pregnancy, and subsequent bipolar and schizophrenia spectrum disorders.ResultsChildren with hospitalizations for asthma between 11 and 15 years had increased rates of bipolar (adjusted hazard ratio [aHR] = 1.73, 95% confidence interval [CI] = 1.21–2.47) and schizophrenia spectrum disorders (aHR = 1.62, 95% CI = 1.08–2.42). However, there was no association with asthma before aged 11. These results were supported by an analysis of siblings discordant for asthma. We found an association between both maternal and paternal asthma and bipolar disorder (aHR = 1.60, 95% CI = 1.27–2.02, and aHR = 1.44, 95% CI = 1.08–1.93, respectively), but not between parental asthma and schizophrenia spectrum disorders.ConclusionsAs far as we are aware, this is the first study to find increased risk of bipolar disorder in children of individuals with asthma. Asthma admissions before aged 11 do not appear to be linked to bipolar or schizophrenia spectrum disorders. Taken together, our results do not suggest a straightforward link between asthma and severe mental illness via neurodevelopmental effects of inflammation, but potentially there is shared genetic vulnerability. This finding has implications for understanding the differential pathogenic mechanisms of bipolar and schizophrenia spectrum disorders.
Highlights
Asthma is a common illness, with considerable medical and psychosocial morbidity and a substantial economic burden, characterized by episodes of breathlessness and wheeze.[1]
40 187 (1.78%) children were admitted with asthma before their 15th birthday and 9892 (0.44%) children were born to mothers who were admitted with asthma admissions before their birth
During follow-up, 12 705 (0.56%) individuals were diagnosed with bipolar disorder and 9940 (0.44%) individuals were diagnosed with schizophrenia spectrum disorders (3325 of these were schizophrenia diagnoses)
Summary
Asthma is a common illness, with considerable medical and psychosocial morbidity and a substantial economic burden, characterized by episodes of breathlessness and wheeze.[1]. Methods: A cohort study including all children born in Sweden 1973–1995 (N > 2 million) assessing associations between childhood hospitalization for asthma, parental asthma during and pre-pregnancy, and subsequent bipolar and schizophrenia spectrum disorders. Results: Children with hospitalizations for asthma between 11 and 15 years had increased rates of bipolar (adjusted hazard ratio [aHR] = 1.73, 95% confidence interval [CI] = 1.21–2.47) and schizophrenia spectrum disorders (aHR = 1.62, 95% CI = 1.08–2.42). Our results do not suggest a straightforward link between asthma and severe mental illness via neurodevelopmental effects of inflammation, but potentially there is shared genetic vulnerability. This finding has implications for understanding the differential pathogenic mechanisms of bipolar and schizophrenia spectrum disorders
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