Asthma and panic in young adults: a 20-year prospective community study.
BACKGROUND
Psychologic factors are increasingly recognized to influence the onset and course of asthma. Previous cross-sectional community-based studies have provided evidence for a relatively specific association between asthma and panic.


OBJECTIVE
To examine concurrent and longitudinal associations between asthma and panic in young adults.


RESULTS
Prospective community-based cohort study of young adults (n = 591) followed between ages 19 and 40. Information was derived from six subsequent semistructured diagnostic interviews conducted by professionals. Cross-sectionally (over the whole study period), asthma was more strongly associated with panic disorder (odds ratio [OR] = 4.0; 95% confidence interval [CI], 1.7, 9.3) than with any panic, which included panic disorder and panic attacks (OR = 2.1; 95% CI, 1.1, 4.5). Longitudinally, after adjusting for potentially confounding variables, active asthma predicted subsequent panic disorder (OR = 4.5; 95% CI, 1.1, 20.1), and the presence of panic disorder predicted subsequent asthma activity (OR = 6.3; 95% CI, 2.8, 14.0). Asthma predicted any panic (OR = 2.7; 95% CI, 1.1, 7.1), whereas any panic did not predict subsequent asthma activity. Associations were stronger in smokers than in nonsmokers, and stronger in women than in men. Smoking, early-childhood anxiety, and a family history of allergy were important confounders of the asthma-panic association.


CONCLUSIONS
This is the first long-term follow-up study on asthma and panic. It showed dose-response-type relationships between panic and asthma, and bidirectional longitudinal associations between the two conditions. It provided evidence for familial factors and smoking as possible shared etiologic explanations.
Hasler
Gregor
G
National Institutes of Health, National Institute of Mental Health, Mood and Anxiety Disorders Program, 15K North Drive, Room 200, MSC 2670, Bethesda, MD 20892-2670, USA. g.hasler@bluewin.ch
Gergen
Peter J
PJ
Kleinbaum
David G
DG
Ajdacic
Vladeta
V
Gamma
Alex
A
Eich
Dominique
D
Rössler
Wulf
W
Angst
Jules
J
D000328:Adult; D001249:Asthma / Q000453:epidemiology* / Q000523:psychology*; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010200:Panic; D016584:Panic Disorder / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D013557:Switzerland / Q000453:epidemiology