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Kids with Asthma and Mental Health Issues Need Close Follow-Up

A new study finds that children with asthma have a higher likelihood of also suffering from anxiety and depression. Moreover, when all three conditions are present, patients are almost twice as likely as those with asthma alone to seek care in the Emergency Room.

ER visits are frequently avoidable and sometimes unnecessary, say researchers at UCSF Benioff Children’s Hospitals, who led the study. ER visits, together with the hospital stays that may follow, account for 61.7% of all asthma-related expenditures for U.S. children, according to the National Medical Expenditure Survey.

UCSF researchers followed more than 65,000 children and youth with asthma, ages 6 to 21. They found that 7.7% of participants with both depression and anxiety had a rate of 28 ER visits per 100 child years. This is almost twice the rate — 16 ER visits per 100 child years — of those without depression and anxiety.

For asthma patients who just had depression, the rate was lower, with 22 visits per 100 child years, and for those asthma patients who just had anxiety, the rate was 19 visits per 100 child years.

“Asthma self-management is complex, requiring recognition of symptoms, adherence to medication and avoidance of triggers,” said first author Naomi Bardach, MD, MAS.

“The symptoms of anxiety and depression can make it more challenging to follow treatment, leading to more ER visits,” she said. “There also may be a greater tendency to use the ER for supportive services, even in the absence of a serious asthma attack.”

The authors noted that anxiety and depression are more common in children with asthma. In their study, 11.2% had anxiety and 5.8% had depression, versus 7.1% and 3.2%, respectively, for children ages 3 to 17, according to data from the Centers for Disease Control and Prevention.

To qualify for the study, the 65,342 participants needed to have had asthma-related doctor visits or hospitalizations, or prior use of preventive medications with an asthma-related doctor visit. They were identified with anxiety and depression if they had at least one inpatient, outpatient or ER visit for either condition.

“The study highlights a population of children and youth who may benefit from more intensive care coordination,” said Bardach.

“This may mean more careful counseling to improve medication compliance and symptom recognition. It may also mean improved mental health care for children in whom untreated depression or anxiety may hinder asthma self-management.”

In some children with asthma, depression and anxiety, it can be difficult to tease out which symptom is attributed to which condition, said senior author Michael Cabana, MD, MPH, formerly of UCSF and currently with Children’s Hospital at Montefiore.

“Children with these conditions may seek care not only for asthma attacks, but for symptoms like shortness of breath, rapid heartbeat and chest pain, of which the causes may be ambiguous.”

The research results confirm studies in adults with asthma who also had depression and anxiety. This group of patients was also found to have a higher likelihood of visits to the ER, urgent care clinics and unscheduled visits with their providers, compared to adults with asthma alone.

Source: UCSF

Kids with Asthma and Mental Health Issues Need Close Follow-Up

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2019). Kids with Asthma and Mental Health Issues Need Close Follow-Up. Psych Central. Retrieved on October 21, 2019, from https://psychcentral.com/news/2019/10/04/kids-with-asthma-and-mental-health-issues-need-close-follow-up/150538.html
Scientifically Reviewed
Last updated: 3 Oct 2019
Last reviewed: By a member of our scientific advisory board on 3 Oct 2019
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