Alicia E. Meuret, Ph.D., Jennifer E. Drake, M.A., Donna B. Pincus, Ph.D., Tina In-Albon & Jill T. Ehrenreich, Ph.D.
Boston University, Boston, MA, USA
Recent studies on adults from clinical and community settings suggest an association between asthma and a range of mental disorders, particularly anxiety disorders. In youth, anxiety disorders among asthmatics are significantly higher than in non-asthmatic peers or youths with other chronic medical illnesses. To date, relatively little is known about the prevalence of children with asthma seeking mental health treatment in clinical settings.
To further investigate the link between childhood anxiety and asthma, we assessed the prevalence rates of asthma in a sample of 376 children and adolescents (age 4-18) seeking psychological treatment for anxiety through the Center for Anxiety and Related Disorders (CARD) at Boston University between 1998 and 2004.
Results indicated that 16% of child and adolescent patients with an Axis I disorder also had an additional diagnosis of asthma, which was three times higher than the ones found in the general child and adolescent asthma population in the US. While generalized anxiety disorder (GAD) ranked highest amongst child and adolescent asthmatics (17%), panic disorder with or without agoraphobia was the most prevalent diagnosis among non-asthmatics (11%). The diagnosis of GAD was nearly twice as high amongst those with asthma, as compared to non-asthmatics (9.8%).
Significant differences were also found between anxious children with asthma and without asthma on child and parent self-report measures:
On the Multidimensional Anxiety Scale for Children, asthmatic children attained significantly higher total scores as well as higher scores on the physical symptoms subscale than children without asthma.
On the Child Anxiety Sensitivity Index, asthmatic children reported higher total scores than non-asthmatic children.
On the Child Behavior Checklist, completed by parents, mothers of asthmatic children reported significantly higher child internalizing symptoms and child externalizing symptoms than mothers of non-asthmatic children.
Mothers of asthmatic children also reported higher levels of general maternal psychopathology on the Depression Anxiety and Stress Scale.