title: Prevalence of anxiety and depressive symptoms in adolescents with asthma: a meta-analysis and meta-regression.
abstract: It remains unclear whether anxiety and depressive symptoms are more prevalent in adolescents with asthma when compared with healthy individuals. This meta-analysis aimed to evaluate the difference in the aggregate prevalence of depressive and anxiety symptoms between adolescents with asthma and healthy controls and to explore the underlying moderators that potentially explain the heterogeneity of the effect size. A meta-analysis of published work was performed using the random effects model. The differences in aggregate prevalence of depressive and anxiety symptoms between adolescents with asthma and healthy controls were determined. Meta-regression and subgroup analysis were performed to identify factors that may contribute to heterogeneity. A total of eight studies were eligible for analysis. The aggregate prevalence of depressive and anxiety symptoms was significantly higher among 3546 adolescents with asthma than that of 24,884 controls (depression, 0.27; 95% CI, 0.18.6-0.39 vs. 0.13; 95% CI, 0.09-0.19; anxiety, 0.33; 95% CI, 0.19-0.52 vs. 0.21; 95% CI, 0.12-0.33). The risk of developing depression and anxiety is significantly higher among adolescents with asthma when compared with controls (depression: pooled odds ratio, 2.09; 95% CI, 1.65-2.64; p < 0.001; anxiety: pooled odds ratio, 1.83; 95% CI, 1.63-2.07; p < 0.001). Meta-regression revealed that the proportions of Caucasian (p = 0.008) and smokers (p < 0.001) were significant moderators which explained the significant heterogeneity when comparing the risk of developing depressive symptoms among adolescent asthma patients vs. controls while age, gender, and severity of asthma were not significant. Family doctors, pediatricians, and healthcare providers should formulate strategies to detect depressive and anxiety symptoms in adolescents with asthma and offer psychological interventions to reduce the burden of psychiatric comorbidity.
authors.affiliation: Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Yanxia
authors.initials: Y
authors.lastname: Lu
authors.forename: Kwok-Kei
authors.initials: KK
authors.lastname: Mak
authors.forename: Hugo P S
authors.initials: HP
authors.lastname: van Bever
authors.forename: Tze Pin
authors.initials: TP
authors.lastname: Ng
authors.forename: Anselm
authors.initials: A
authors.lastname: Mak
authors.forename: Roger Chun-Man
authors.initials: RC
authors.lastname: Ho
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology*; D001249:Asthma / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence