title: Higher risk of developing major depression and bipolar disorder in later life among adolescents with asthma: a nationwide prospective study.
abstract: OBJECTIVE
  Previous studies have suggested an immunological dysfunction in mood disorders, but rarely have investigated the temporal association between allergic diseases and mood disorders. Using the Taiwan National Health Insurance Research Database, we attempted to investigate the association between asthma in early adolescence and the risk of unipolar depression and bipolar disorder in later life.
  
  
  METHODS
  In all, 1453 adolescents with asthma aged between 10 and 15 years and 5812 age-/gender-matched controls were selected in 1998-2000. Subjects with unipolar depression and bipolar disorder that occurred up to the end of follow-up (December 31 2010) were identified.
  
  
  RESULTS
  Adolescents with asthma had a higher incidence of major depression (2.8% vs. 1.1%, p < 0.001), any depressive disorder (6.1% vs. 2.6%, p < 0.001), and bipolar disorder (1.0% vs. 0.3%, p < 0.001) than the control group. Cox regression analysis showed that asthma in early adolescence was associated with an increased risk of developing major depression (hazard ratio [HR]: 1.81, 95% confidence interval [CI]: 1.14-2.89), any depressive disorder (HR: 1.74, 95% CI: 1.27-2.37), and bipolar disorder (HR: 2.27, 95% CI: 1.01-5.07), after adjusting for demographic data and comorbid allergic diseases.
  
  
  CONCLUSIONS
  Adolescents with asthma had an elevated risk of developing mood disorders in later life. Further studies would be required to investigate the underlying mechanisms for this comorbid association and elucidate whether prompt intervention for asthma would decrease the risk of developing mood disorders.
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Mu-Hong
authors.initials: MH
authors.lastname: Chen
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Tung-Ping
authors.initials: TP
authors.lastname: Su
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Ying-Sheue
authors.initials: YS
authors.lastname: Chen
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Ju-Wei
authors.initials: JW
authors.lastname: Hsu
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Kai-Lin
authors.initials: KL
authors.lastname: Huang
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Wen-Han
authors.initials: WH
authors.lastname: Chang
authors.affiliation: Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.affiliation: Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: ymbi@mail2000.com.tw.
authors.forename: Ya-Mei
authors.initials: YM
authors.lastname: Bai
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology*; D001714:Bipolar Disorder / Q000453:epidemiology*; D002648:Child; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D009313:National Health Programs / Q000706:statistics & numerical data; D011897:Random Allocation; D012044:Regression Analysis; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: Asthma; Bipolar disorder; Major depression