title: Association between mental disorders and subsequent adult onset asthma.
abstract: OBJECTIVE
  Associations between asthma and anxiety and mood disorders are well established, but little is known about their temporal sequence. We examined associations between a wide range of DSM-IV mental disorders with adult onset of asthma and whether observed associations remain after mental comorbidity adjustments.
  
  
  METHODS
  During face-to-face household surveys in community-dwelling adults (n = 52,095) of 19 countries, the WHO Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Asthma was assessed by self-report of physician's diagnosis together with age of onset. Survival analyses estimated associations between first onset of mental disorders and subsequent adult onset asthma, without and with comorbidity adjustment.
  
  
  RESULTS
  1860 adult onset (21 years+) asthma cases were identified, representing a total of 2,096,486 person-years of follow up. After adjustment for comorbid mental disorders several mental disorders were associated with subsequent adult asthma onset: bipolar (OR = 1.8; 95%CI 1.3-2.5), panic (OR = 1.4; 95%CI 1.0-2.0), generalized anxiety (OR = 1.3; 95%CI 1.1-1.7), specific phobia (OR = 1.3; 95%CI 1.1-1.6); post-traumatic stress (OR = 1.5; 95%CI 1.1-1.9); binge eating (OR = 1.8; 95%CI 1.2-2.9) and alcohol abuse (OR = 1.5; 95%CI 1.1-2.0). Mental comorbidity linearly increased the association with adult asthma. The association with subsequent asthma was stronger for mental disorders with an early onset (before age 21).
  
  
  CONCLUSIONS
  A wide range of temporally prior mental disorders are significantly associated with subsequent onset of asthma in adulthood. The extent to which asthma can be avoided or improved among those with early mental disorders deserves study.
authors.affiliation: Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Pompeu Fabra University (UPF), Barcelona, Spain. Electronic address: jalonso@imim.es.
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.affiliation: Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center, University of Groningen, Groningen, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: de Jonge
authors.affiliation: Department of Psychological Medicine, Otago University, Dunedin, New Zealand.
authors.forename: Carmen C W
authors.initials: CC
authors.lastname: Lim
authors.affiliation: University of California, Davis, Center for Reducing Health Disparities, School of Medicine, Sacramento, CA, USA.
authors.forename: Sergio
authors.initials: S
authors.lastname: Aguilar-Gaxiola
authors.affiliation: Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC - KUL), Leuven, Belgium.
authors.forename: Ronny
authors.initials: R
authors.lastname: Bruffaerts
authors.affiliation: Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciencias Medicas, Universidade Nova de Lisboa, Lisbon, Portugal.
authors.forename: Jose Miguel
authors.initials: JM
authors.lastname: Caldas-de-Almeida
authors.affiliation: Institute of Mental Health, Peking University, Beijing, PR China.
authors.forename: Zhaorui
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Bamford Centre for Mental Health and Well-Being, University of Ulster, Derry, Northern Ireland, UK.
authors.forename: Siobhan
authors.initials: S
authors.lastname: O'Neill
authors.affiliation: University of Cape Town, Department of Psychiatry & Mental Health, Groote Schuur Hospital, Cape Town, South Africa.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.affiliation: Department of Social Medicine, Federal University of Espírito Santo (UFES), Vitória, Brazil.
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Viana
authors.affiliation: Al-Qadisia University College of Medicine, Diwania, Iraq.
authors.forename: Ali Obaid
authors.initials: AO
authors.lastname: Al-Hamzawi
authors.affiliation: Center for Public Mental Health, Gosing am Wagram, Austria.
authors.forename: Matthias C
authors.initials: MC
authors.lastname: Angermeyer
authors.affiliation: Division of Epidemiological and Psychosocial Research, National Institute of Psychiatry (Mexico) and Metropolitan Autonomous University, Mexico City, Mexico.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Borges
authors.affiliation: National School of Public Health and Professional Development, Bucharest, Romania.
authors.forename: Marius
authors.initials: M
authors.lastname: Ciutan
authors.affiliation: IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.affiliation: Evidence Generation for Public Health Research Unit, National Institute of Health, Lima, Peru.
authors.forename: Fabian
authors.initials: F
authors.lastname: Fiestas
authors.affiliation: Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; CIBER de Salud Mental (CIBERSAM), Spain; University of Barcelona, Barcelona, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
authors.affiliation: Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Guangdong Province, PR China.
authors.forename: Chiyi
authors.initials: C
authors.lastname: Hu
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.affiliation: Hôpital Saint-Louis Lariboisière Fernand Widal, INSERM U 705, CNRS UMR 8206, Paris, France.
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Lépine
authors.affiliation: Mental Health Services, Ministry of Health, Jerusalem, Israel.
authors.forename: Daphna
authors.initials: D
authors.lastname: Levinson
authors.affiliation: Department of Public Health, Jichi Medical University, Yakushiji, Shimotsuke-shi, Tochigi-ken, Japan.
authors.forename: Yosikazu
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Colegio Mayor de Cundinamarca University, CALLE 28 No. 5B-02, Bogota, DC, Colombia.
authors.forename: Jose
authors.initials: J
authors.lastname: Posada-Villa
authors.affiliation: Department-Centre of Monitoring and Analyses of Population Health, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland.
authors.forename: Bogdan J
authors.initials: BJ
authors.lastname: Wojtyniak
authors.affiliation: Department of Psychological Medicine, Otago University, Dunedin, New Zealand.
authors.forename: Kate M
authors.initials: KM
authors.lastname: Scott
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003431:Cross-Cultural Comparison; D005260:Female; D014943:Global Health / Q000706:statistics & numerical data; D006801:Humans; D007391:International Cooperation; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000453:epidemiology*; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: Asthma; Chronic disease; Comorbidity; Epidemiology; Mental disorders; Population