Psychosocial stress and asthma morbidity.
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ABSTRACT:
SUBMITTER: Yonas MA
PROVIDER: S-EPMC3320729 | biostudies-literature | 2012 Apr
REPOSITORIES: biostudies-literature
Publications
Psychosocial stress and asthma morbidity.
Yonas Michael A MA Lange Nancy E NE Celedón Juan C JC
Current opinion in allergy and clinical immunology 20120401 2
<h4>Purpose of review</h4>The objective of this review is to provide an overview and discussion of recent epidemiologic and mechanistic studies of stress in relation to asthma incidence and morbidity.<h4>Recent findings</h4>Recent findings suggest that stress, whether at the individual (i.e. epigenetics, perceived stress), family (i.e. prenatal maternal stress, early-life exposure, or intimate partner violence) or community (i.e. neighborhood violence; neighborhood disadvantage) level, influence ...[more]
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Project description:BackgroundLittle is known about paternal psychosocial factors and childhood asthma.ObjectiveWe sought to examine the link between maternal and paternal psychosocial stress and asthma outcomes in young children.MethodsParents of 339 pairs of Puerto Rican twins were interviewed individually about their own psychosocial stress and about asthma in their children at age 1 year and again about their child's asthma at age 3 years. Fathers were asked about symptoms of posttraumatic stress disorder (PTSD), depression, and antisocial behavior. Mothers were asked about depressive symptoms. Outcomes assessed in children included recent asthma symptoms, oral steroid use and hospitalizations for asthma in the prior year, and asthma diagnosis. Generalized estimated equation models were used for the multivariate analysis of parental psychosocial stress and asthma morbidity in childhood.ResultsAfter multivariable adjustment, paternal PTSD symptoms, depression, and antisocial behavior were each associated with increased asthma symptoms at age 1 year (eg, odds ratio, 1.08 for each 1-point increase in PTSD score; 95% CI, 1.03-1.14). Maternal depressive symptoms were associated with an increased risk of asthma hospitalizations at age 1 year. At age 3 years, maternal depressive symptoms were associated with asthma diagnosis and hospitalizations for asthma (odds ratio for each 1-point increase in symptoms, 1.16; 95% CI, 1.00-1.36). In an analysis combining 1- and 3-year outcomes, paternal depression was associated with oral steroid use, maternal depressive symptoms were associated with asthma hospitalizations and asthma diagnosis, and parental depression was associated with hospitalizations for asthma.ConclusionsBoth paternal and maternal psychosocial factors can influence asthma morbidity in young Puerto Rican children.
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Project description:The aim of this study was to investigate whether neighborhood safety as perceived by primary caregivers is associated with asthma morbidity outcomes among inner-city school children with asthma.School children with asthma were recruited from 25 inner-city schools between 2009 and 2012 for the School Inner-City Asthma Study (N?=?219). Primary caregivers completed a baseline questionnaire detailing their perception of neighborhood safety and their children's asthma symptoms, and the children performed baseline pulmonary function tests. In this cross-sectional analysis, asthma control was compared between children whose caregivers perceived their neighborhood to be unsafe versus safe.After adjusting for potential confounders, those children whose primary caregivers perceived the neighborhood to be unsafe had twice the odds of having poorly controlled asthma (odds ratio [OR] adjusted?=?2.2, 95% confidence interval [CI]?=?1.2-3.9, P?=?0.009), four times the odds of dyspnea and rescue medication use (OR adjusted?=?4.7; 95% CI?=?1.7-13.0, P?=?0.003, OR adjusted?=?4.0; 95% CI?=?1.8-8.8, P?<?0.001, respectively), three times as much limitation in activity (OR adjusted?=?3.2; 95% CI?=?1.4-7.7, P?=?0.008), and more than twice the odds of night-time symptoms (OR adjusted?=?2.2; 95% CI?=?1.3-4.0, P?=?0.007) compared to participants living in safe neighborhoods. There was no difference in pulmonary function test results between the two groups.Primary caregivers' perception of neighborhood safety is associated with childhood asthma morbidity among inner-city school children with asthma. Further study is needed to elucidate mechanisms behind this association, and future intervention studies to address social disadvantage may be important.
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