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Author Notes:

Please address correspondence to: Anne M. Fitzpatrick, Ph.D., 2015 Uppergate Drive, Atlanta, Georgia 30322, Telephone: 404-727-9112, Facsimile: 404-712-0920, anne.fitzpatrick@emory.edu

Subjects:

Research Funding:

This study was supported by R01 NR013700 and was supported in part by the National Center for Advancing Translational Sciences of the National Institutes of Health, award number UL1 TR000454

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Allergy
  • Immunology
  • Asthma control
  • Asthma exacerbation
  • Mental health
  • Adolescent
  • Anxiety
  • QUALITY-OF-LIFE
  • HOSPITAL ANXIETY
  • MENTAL-HEALTH
  • UNITED-STATES
  • DEPRESSION SCALE
  • CYSTIC-FIBROSIS
  • RACIAL DISPARITIES
  • DISORDERS
  • PREVALENCE
  • CHILDREN

Anxiety Contributes to Poorer Asthma Outcomes in Inner-City Black Adolescents

Tools:

Journal Title:

Journal of Allergy and Clinical Immunology: In Practice

Volume:

Volume 6, Number 1

Publisher:

, Pages 227-235

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background The factors associated with poor asthma control, exacerbations, and health care utilization in black adolescents are complex and not well understood. Although psychological comorbidities such as anxiety are common in patients with asthma, these have not been studied in this population. Objective This study characterized anxiety and associated asthma features in a cohort of black inner-city adolescents with persistent asthma and determined the association between anxiety symptoms, persistent uncontrolled asthma, and prospective health care utilization over 1 year. Methods Eighty-six black adolescents were enrolled, phenotyped, and screened for anxiety symptoms with the Hospital Anxiety and Depression Scale anxiety subscale (HADS-A). Participants were telephoned every 2 months and a second study visit was completed at 1 year. Primary outcomes included persistent uncontrolled asthma, asthma exacerbations requiring systemic corticosteroids, and unscheduled health care utilization during the 1-year study period. Results A total of 31% (n = 27) of adolescents had probable anxiety (ie, HADS-A score >7) and 27% (n = 23) had possible anxiety (ie, HADS-A score 5-7) at the baseline visit. Anxiety symptoms were associated with poorer asthma control, more impaired quality of life, and more insomnia symptoms. Adolescents with probable anxiety disorders also had increased odds of persistent uncontrolled asthma and emergency department utilization, with no differences in physician visits or systemic corticosteroid receipt. Conclusions Inner-city black adolescents with persistent asthma have a high prevalence of anxiety symptoms associated with poorer asthma control, impaired quality of life, insomnia, and increased prospective emergency department utilization for asthma. Routine screening for anxiety disorders may be useful in the clinical management of adolescents with asthma.

Copyright information:

© 2017 American Academy of Allergy, Asthma & Immunology

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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