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Comorbidity with depression and overweight in children with asthma

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Background

In Canada 16.6% of children are affected by asthma [1] which may increase the risk of comorbid depressive disorders in the adolescent years [2, 3]. Overweight is more prevalent in children suffering from asthma [4] or depression [5], yet few studies have explored the possible relationships between these three chronic conditions in children. We examined whether depression was more prevalent in children with asthma, especially among those who were overweight.

Materials and methods

Data were collected as a part of the nested case-control study of the Study of Asthma, Genes and Environment (SAGE) cohort in Manitoba. All the children enrolled in the study at age 7-10 were reassessed by a pediatric allergist at 11-13 years to confirm asthma/atopy diagnosis. At the same visit, height and weight were obtained. Depressive symptoms were also assessed using the short form of the children’s depression inventory (CDI-S). Depression was defined as CDI-S scores ≥2 (highest quartile of population under the study). Overweight was defined as BMI-z score > 1.04. Data were analyzed using logistic regression modeling to determine likelihood of depression in children with asthma, stratified by sex and adjusting for age, overweight and atopy.

Results

A total of 485 children at 11-13 years (150 asthmatics and 335 non asthmatics) were enrolled in the study (Table 1). There was no statistically significant difference in overweight between children with versus without asthma (p= 0.4) and we found the prevalence of depression to be similar among those with (33.8%) versus without (28.1%) asthma (p= 0.2). Overweight was associated with higher odds of depression in girls independent of age and asthma/atopy status (adjusted OR=2.1, 95% CI= 1.02 to 4.22). In addition, asthmatic boys were more likely to experience depression after adjusting for age, overweight and atopy (adjusted OR=1.94, 95% CI=1.01 to 3.71) (Table 2).

Table 1 Basic distribution of study variables
Table 2 Likelihood of depression in children

Conclusions

Overweight appears to be an important predictor of depression in girls regardless of their asthma status. Although asthma status does not increase the likelihood of depression in girls, it appears to increase the odds of depression among boys.

References

  1. 1.

    Public health agency of Canada: Life and breath: respiratory disease in Canada, 2007. Ottawa: public health agency of Canada, 41-Cat.: HP35-8/2007E-PDF.

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    Ortega AN, Huertas SE, Canino G, Ramirez R, Rubio-Stipec M: Childhood asthma, chronic illness, and psychiatric disorders. J Nerv Ment Dis. 2002, 190: 275-81. 10.1097/00005053-200205000-00001.

  3. 3.

    McQuaid EL, Kopel SJ, Nassau JH: Behavioral adjustment in children with asthma: a meta-analysis. J Dev Behav Pediatr. 2001, 22: 430-9.

  4. 4.

    Vahlkvist S, Pedersen S: Fitness, daily activity and body composition in children with newly diagnosed, untreated asthma. Allergy. 2009, 64: 1649-1655. 10.1111/j.1398-9995.2009.02081.x.

  5. 5.

    Anderson SE, Cohen P, Naumova EN, Jacques PF, Must A: Adolescent obesity and risk for subsequent major depressive disorder and anxiety disorder: prospective evidence. Psychosom Med. 2007, 69: 740-747. 10.1097/PSY.0b013e31815580b4.

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Acknowledgments

This research was funded by AllerGen NCE Inc and the Canadian Institutes of Health Research: new emerging team and operating grants in origins of asthma. Salma Bahreinian is supported by the Women and Children’s Health Research Institute. We would also like to acknowledge the support of the SAGE research team.

Author information

Correspondence to Salma Bahreinian.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Keywords

  • Public Health
  • Asthma
  • Logistic Regression
  • Regression Modeling
  • Depressive Symptom