Psychiatric Comorbidities in Asian Adolescent Asthma Patients and the Contributions of Neuroticism and Perceived Stress

Abstract

Psychiatric comorbidity is reported to be common among adolescents with asthma, but little is known about its underlying psychological factors. This study explored the profile of anxiety and depressive comorbidities among adolescents with well-controlled and poorly controlled asthma and the contribution of neuroticism and perceived stress. The Revised Child Anxiety and Depression Scale, Neuroticism subscale of Big Five Inventory, Perceived Stress Scale, and Asthma Control Test were administered to 198 adolescents (aged 12-19years) with well-controlled (n= 137) and poorly controlled asthma (n= 61) as well as 171 healthy neighborhood controls. Adolescents with poorly controlled asthma, compared with well-controlled asthma patients and healthy controls, had higher scores of depression (p= .006), panic attacks (p= .002), total anxiety (p= .038), and total internalizing symptoms (p= .017), after adjusting for gender, age, ethnicity, smoking status, and family housing type. Adolescents with asthma had higher neuroticism (p= .025), perceived stress (p= .022), and body mass index (p= .006) and lower self-rated health (p < .001) than healthy controls. No significant differences in psychiatric comorbidity scores were observed after accounting for differences in underlying psychological and physical factors. Among asthma patients, increased asthma control was associated with decreased scores of psychiatric comorbidity (p < .01), but the association was not significant after allowing for decreased neuroticism and perceived stress. The diagnosis of asthma and poor asthma control in adolescents is associated with excess psychiatric comorbidity, which is likely due to increased neuroticism and perceived stress.