Abstract
Objectives
Asthma is the most common chronic disease of childhood in the United States, disproportionately
affecting urban, poor, and minority children. Adolescents are at high risk for poor
asthma outcomes and for depressive symptoms. The purpose of this study is to investigate
associations between depressive symptoms and asthma-related clinical and functional
outcomes among urban teens.
Methods
We used baseline data from a 3-arm randomized trial, School-Based Asthma Care for
Teens, in Rochester, NY. We used the Center for Epidemiological Studies Depression
Scale with a standard cutoff score of 16 to identify subjects at risk for clinical
depression. We used structured in-home surveys and validated scales to assess clinical
and functional outcomes and conducted bivariate and multivariate analyses to evaluate
differences between groups.
Results
We identified 277 eligible teens (ages 12 to 16, 80% participation, 54% black, 34%
Hispanic, 45% female, 84% on Medicaid). Overall, 28% reported depressive symptoms.
Teens with depressive symptoms experienced greater asthma symptom severity and more
acute health care utilization for asthma (all P < .001); however, there was no difference in preventive care use between groups.
Teens with depressive symptoms also reported lower asthma-related quality of life
(P < .001), less sleep (P < .001), and more limitation in mild (adjusted odds ratio [aOR], 2.60; 95% confidence
interval [CI], 1.34–5.02) and moderate (aOR, 2.56; 95% CI, 1.41–4.61) activity and
in gym (aOR, 2.33; 95% CI, 1.30–4.17).
Conclusions
Depressive symptoms are prevalent among urban teens with asthma and are associated
with worse asthma-related clinical outcomes, functional limitation, and quality of
life. Providers should consider depression as a significant comorbidity that may impact
multiple aspects of daily life for this population.
Keywords
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Article info
Publication history
Published online: December 19, 2018
Accepted:
December 14,
2018
Received:
August 2,
2018
Footnotes
The authors have no conflicts of interest to disclose.
Presented in part at the Pediatric Academic Societies meeting, May 5, 2018, Toronto, Ontario.
Identification
Copyright
Copyright © 2018 by Academic Pediatric Association
