title: Psychiatric comorbidities in Asian adolescent asthma patients and the contributions of neuroticism and perceived stress.
abstract: OBJECTIVE
  Psychiatric comorbidity is reported to be common among adolescents with asthma, but little is known about its underlying psychological factors.
  
  
  OBJECTIVE
  This study explored the profile of anxiety and depressive comorbidities among adolescents with well-controlled and poorly controlled asthma and the contribution of neuroticism and perceived stress.
  
  
  METHODS
  The Revised Child Anxiety and Depression Scale, Neuroticism subscale of Big Five Inventory, Perceived Stress Scale, and Asthma Control Test were administered to 198 adolescents (aged 12-19 years) with well-controlled (n = 137) and poorly controlled asthma (n = 61) as well as 171 healthy neighborhood controls.
  
  
  RESULTS
  Adolescents with poorly controlled asthma, compared with well-controlled asthma patients and healthy controls, had higher scores of depression (p = .006), panic attacks (p = .002), total anxiety (p = .038), and total internalizing symptoms (p = .017), after adjusting for gender, age, ethnicity, smoking status, and family housing type. Adolescents with asthma had higher neuroticism (p = .025), perceived stress (p = .022), and body mass index (p = .006) and lower self-rated health (p < .001) than healthy controls. No significant differences in psychiatric comorbidity scores were observed after accounting for differences in underlying psychological and physical factors. Among asthma patients, increased asthma control was associated with decreased scores of psychiatric comorbidity (p < .01), but the association was not significant after allowing for decreased neuroticism and perceived stress.
  
  
  CONCLUSIONS
  The diagnosis of asthma and poor asthma control in adolescents is associated with excess psychiatric comorbidity, which is likely due to increased neuroticism and perceived stress.
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.affiliation: Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Roger
authors.initials: R
authors.lastname: Ho
authors.affiliation: Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital System, Singapore.
authors.forename: Tow Keang
authors.initials: TK
authors.lastname: Lim
authors.affiliation: Department of Emergency Medicine, National University Health System, Singapore.
authors.forename: Win Sen
authors.initials: WS
authors.lastname: Kuan
authors.affiliation: Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Daniel Yam Thiam
authors.initials: DY
authors.lastname: Goh
authors.affiliation: Department of Emergency Medicine, National University Health System, Singapore.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Mahadevan
authors.affiliation: Department of Emergency Medicine, National University Health System, Singapore.
authors.forename: Tiong Beng
authors.initials: TB
authors.lastname: Sim
authors.affiliation: Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: pcmngtp@nus.edu.sg.
authors.forename: Tze-Pin
authors.initials: TP
authors.lastname: Ng
authors.affiliation: Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Hugo P S
authors.initials: HP
authors.lastname: van Bever
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000704:Analysis of Variance; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D044466:Asian People / Q000523:psychology; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D016009:Chi-Square Distribution; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D000075384:Neuroticism; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D012649:Self Concept; D012720:Severity of Illness Index; D017678:Sex Distribution; D012846:Singapore / Q000453:epidemiology; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D055815:Young Adult
keywords: Adolescent; Asthma control; Neuroticism; Perceived stress; Psychiatric comorbidity; Risk factors