title: Anxiety, depression and self-esteem in children with well-controlled asthma: case-control study.
abstract: OBJECTIVE
  Although asthma has been linked to psychological morbidity, this relationship may be confounded by poor asthma control. We aimed to compare the prevalence of anxiety, depression and low level of self-esteem in children with well-controlled asthma with that of healthy peers.
  
  
  METHODS
  Dedicated asthma clinic in a general hospital.
  
  
  METHODS
  70 patients with mostly well-controlled asthma and 70 matched healthy controls.
  
  
  METHODS
  Comprehensive asthma education, management and follow-up for asthma patients.
  
  
  METHODS
  Validated Dutch versions of the Childhood Depression inventory (CDI), Revised Fear Survey for Children (RFSC), Self Perception Profile for Children (SPC-C) and Adolescents (SPC-A) and State-Trait Anxiety Inventory for Children (STAIC). Asthma control assessed by asthma control questionnaire.
  
  
  RESULTS
  No significant differences were found in total scores between asthmatics and controls (95% CI for difference -0.2 to 2.9 for CDI, -5.9 to 11.2 for RFSC, -19.9 to 6.3 for SPC-C, -24.1 to 5.0 for SPC-A and -2.7 to 0.01 for STAIC). There were also no significant differences between asthmatics and controls in the prevalence of scores exceeding cut-off levels for clinically relevant anxiety (13.3 vs 13.0%, p=0.605), depression (12.9 vs 5.7%, p=0.243) or low self-esteem (21.4 vs 12.9%, p=0.175). A significant correlation was found between poorer asthma control and CDI (p=0.012) and anxiety trait symptoms (p<0.001).
  
  
  CONCLUSIONS
  Children with well-controlled asthma enrolled in a comprehensive asthma management programme do not have an increased risk of anxiety, depression and poor self-esteem. Earlier reports of psychological comorbidity in asthma may have been related to inadequately controlled asthma.
authors.affiliation: Princess Amalia children's centre, Isala Hospital, Zwolle, The Netherlands.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Letitre
authors.affiliation: Princess Amalia children's centre, Isala Hospital, Zwolle, The Netherlands.
authors.forename: Eric P
authors.initials: EP
authors.lastname: de Groot
authors.affiliation: Princess Amalia children's centre, Isala Hospital, Zwolle, The Netherlands UMCG Postgraduate School of Medicine, University Medical Centre and University of Groningen, Groningen, The Netherlands.
authors.forename: Eelco
authors.initials: E
authors.lastname: Draaisma
authors.affiliation: Princess Amalia children's centre, Isala Hospital, Zwolle, The Netherlands UMCG Postgraduate School of Medicine, University Medical Centre and University of Groningen, Groningen, The Netherlands.
authors.forename: Paul L P
authors.initials: PL
authors.lastname: Brand
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D001249:Asthma / Q000150:complications*; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012649:Self Concept; D011795:Surveys and Questionnaires
keywords: Psychology; Respiratory