title: Asthma and psychiatric disorders in male army recruits and soldiers.
abstract: BACKGROUND
  Numerous studies have shown an association between asthma and mental disorders. While elevated rates of asthma have been noted among psychiatric patients with anxiety disorders and post-traumatic stress disorder, several studies have found elevated rates of mental disorders among asthma patients. Such studies, however, have generally relied upon questionnaires and assessment by non-specialist physicians to diagnose mental disorders and asthma.
  
  
  OBJECTIVE
  To examine a possible association between asthma and psychiatric diagnoses in Israeli military recruits and soldiers.
  
  
  METHODS
  In this cross-sectional study we compared the prevalence of mental diagnoses in asthmatic recruits and soldiers with that in non-asthmatic recruits and soldiers. A total of 195,903 recruits and soldiers were examined by Israel Defense Forces recruiting offices and fitness boards. Diagnoses of asthma were based on a pulmonologist's diagnosis, including spirometry at rest and exercise testing as indicated; diagnoses of mental disorders were based on examination by a psychiatrist.
  
  
  RESULTS
  The prevalence of asthma was found to be 7.8% (current) and 9.8% (lifetime). The prevalence of mental disorders was 13.4%. Current asthma was associated with an increased likelihood of any mental disorder (OR = 1.20, 95% Cl = 1.15-1.26), and specifically with mood and anxiety disorders (1.31, 1.19-1.46), introvert personality disorders (1.20, 1.12-1.28) and adjustment disorder (1.43, 1.26-1.62). Lifetime asthma was associated with an increased likelihood of the same disorders, but the association was not as powerful.
  
  
  CONCLUSIONS
  The results validate the previously documented association between asthma and mental disorders, using a sample of unprecedented size and improved methodology. A multidisciplinary approach to asthma that incorporates mental health professionals in the treatment of poorly controlled asthma and perhaps of asthma in general is recommended.
authors.affiliation: Division of Pediatrics, Soroka University Hospital, Israel. shirafi@netvision.net.il
authors.forename: Raffi
authors.initials: R
authors.lastname: Lev-Tzion
authors.forename: Tal
authors.initials: T
authors.lastname: Friedman
authors.forename: Tzippy
authors.initials: T
authors.lastname: Shochat
authors.forename: Eliyahu
authors.initials: E
authors.lastname: Gazala
authors.forename: Yonit
authors.initials: Y
authors.lastname: Wohl
mesh_terms: D001249:Asthma / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008889:Military Personnel; D015995:Prevalence