title: Stressful life events promote the manifestation of asthma and atopic diseases.
abstract: BACKGROUND
  Psychosocial stress is known to aggravate asthma. Less is known about the impact of stressful life events on the expression of asthma and atopic disorders.
  
  
  OBJECTIVE
  To determine whether the onset of asthma, allergic rhinitis or conjunctivitis, and atopic dermatitis, are associated with stressful life events.
  
  
  METHODS
  A postal survey on risk factors for asthma and atopic diseases was carried out among 10 667 Finnish first-year university students aged 18-25 years. Stressful life events, (i) severe disease or death of a family member, and (ii) parental or personal conflicts, were retrospectively recorded during the preceding year, 1-5 years, 6-10 years, and more than 10 years prior to the survey response. In a case-control setting, conditional multiple logistic regression analysis was used to assess the temporal association between major stressful life events occurring during a period either preceding, concomitant or subsequent with subject's diagnoses.
  
  
  RESULTS
  Concomitant parental and personal conflicts increased the risk of asthma (OR 1.72, 95% CI 1.10-2.69) when adjusted by parental asthma, education and passive smoking at early age. Concomitant severe disease or death of mother, father or spouse (OR 1.52, 95% CI 1.09-2.16) and precedent parental and personal conflicts (OR 1.75, 95% CI 1.15-2.77) increased the risk of manifestation of allergic rhinoconjunctivitis when adjusted for parental atopic disease, education and passive smoking. Subjects' asthma and atopic dermatitis, but not allergic rhinoconjunctivitis, were related to excess of subsequent stressful life events.
  
  
  CONCLUSIONS
  An association between stressful life events and subjects' asthma, allergic rhinoconjunctivitis and atopic dermatitis is suggested.
authors.affiliation: Department of Pulmonary Diseases and Clinical Allergology, University of Turku Central Hospital, Kiinamyllynkatu 4-8, FIN-20520 Turku, Finland. maritta.kilpelainen@utu.fi
authors.forename: M
authors.initials: M
authors.lastname: Kilpeläinen
authors.forename: M
authors.initials: M
authors.lastname: Koskenvuo
authors.forename: H
authors.initials: H
authors.lastname: Helenius
authors.forename: E O
authors.initials: EO
authors.lastname: Terho
mesh_terms: D000328:Adult; D001249:Asthma / Q000503:physiopathology* / Q000523:psychology*; D016022:Case-Control Studies; D003233:Conjunctivitis, Allergic / Q000503:physiopathology / Q000523:psychology; D003876:Dermatitis, Atopic / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000503:physiopathology* / Q000523:psychology*; D008297:Male; D012221:Rhinitis, Allergic, Perennial / Q000503:physiopathology / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires