title: Association of psychiatric disorders and different indicators of asthma in island Puerto Rican children.
abstract: BACKGROUND
  We examined the relationship between three different indicators of childhood asthma (asthma diagnosis, ever had an asthma attack, and asthma hospitalization) and having any psychiatric disorder, comorbid disorders, or specific disorders. Three study hypotheses were examined: 1) there will be subject variability in responses to the asthma indicators; 2) there will be different observed associations between the three asthma indicators and psychiatric disorders; and 3) maternal mental health, family income, and maternal education will confound the associations between childhood asthma and psychiatric disorders.
  
  
  METHODS
  Data were drawn from a community-based, random sample of 1,891 island Puerto Rican children aged 4-17 years. Information was collected through direct interview with children and adolescents and their primary caretakers. The Diagnostic Interview Schedule for Children (DISC) was used to determine DSM-IV diagnoses.
  
  
  RESULTS
  Thirty-two percent of the children had been diagnosed with asthma but only 22 % had ever experienced an asthma attack. Seventeen percent of the children had been hospitalized for asthma. Having been hospitalized for asthma was not associated with any of the psychiatric disorders, having a diagnosis was associated with some of the disorders, and having experienced an asthma attack was associated with almost all the disorders, after controlling for family income and maternal education and mental health.
  
  
  CONCLUSIONS
  Determining and measuring asthma may be difficult because of confusion and differing perceptions of what constitutes asthma or an asthma attack. Future studies should consider the problems in capturing perceptions of asthma and severity in Puerto Rican children and should continue to explore the relationship between asthma and mental illness.
authors.affiliation: Yale University, Department of Epidemiology and Public Health, Division of Health Policy and Administration, 60 College Street, P. O. Box 208034, New Haven, CT 06520-8034, USA. alexander.ortega@yale.edu
authors.forename: Alexander N
authors.initials: AN
authors.lastname: Ortega
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: McQuaid
authors.forename: Glorisa
authors.initials: G
authors.lastname: Canino
authors.forename: Rafael
authors.initials: R
authors.lastname: Ramirez
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Fritz
authors.forename: Robert B
authors.initials: RB
authors.lastname: Klein
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011647:Puerto Rico / Q000453:epidemiology