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 “The original literature, mostly from America,
suggested that kids with asthma were at risk for anxiety, depression
and low self-esteem, but that’s not what we’ve encountered in our
clinical practice,” said the lead author of a new study, Professor
Paul Brand, who works with asthmatic children at Princess Amalia
Childrens Center at Isala Hospital in Zwolle, The Netherlands.
Earlier research probably included many children who did not take
their daily medications as prescribed, he said. When kids take the
necessary medicines, they don’t appear to be any worse off
psychologically than other children.
He and his team compared 70 children from their clinic with mostly
well-controlled asthma and aged 8 to 15 years old, to 70 of their
friends, who were similar in many ways but did not have asthma.
All the children filled out age-appropriate questionnaires meant to
assess depression, anxiety and self-esteem. They also answered
questions about how well they controlled their wheezing and
symptoms.
Hospital data included how long the children with asthma had the
condition, their medication use and exposure to tobacco smoke.
Only 10 of the children with asthma didn’t have it well controlled,
meaning they had had an instance when asthma had worsened in the
past year, less than healthy lung function and a low score on the
asthma management scale.
On the whole, asthmatic kids and their healthy peers scored about
the same on the psychological assessments, the authors write in the
journal Archives of Disease in Childhood. Between 10 and 20 percent
of kids in both groups showed signs of depression, anxiety or
low-self esteem.
But kids with poorly controlled asthma tended to score higher on the
anxiety questionnaire than kids with well controlled asthma.
“It was sort of common sense that if you are doing well with any
kind of chronic illness you won’t have the psychological risks,” Dr.
Andrew Ting told Reuters Health by phone.
Ting, who wasn’t part of the study, specializes in pediatric
pulmonology at Mount Sinai Hospital in New York.
It is very possible to control asthma completely, Brand told Reuters
Health by phone.
“If you can work with kids and their parents to agree on daily use
of inhaled corticosteroids and appropriate use of rescue medications
when necessary, you can really control most asthma,” he said.
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A rescue inhaler, like Albuterol, helps to relax the airways during
an asthma attack. Children with persistent asthma should also be
using a corticosteroid inhaler, like Advair, every day to help
reduce airway inflammation and lower mucus levels, he said.
But many children don’t use their daily inhaler, Brand said. “In
order to insure adherence, you need to invest in the relationship
with kids and their parents,” which is more common in western Europe
than in the U.S., he noted.
“The question is, how do you do that in today’s medical economic
climate, how do you carve out the time to make that kind of a
relationship with the patients?” Ting said.
It’s impossible to really encourage patients to adhere to a good
action plan in a five to ten minute doctor’s visit, he said. At
Mount Sinai they have a social worker go over the asthma management
plan with patients in more detail outside of a doctor’s appointment,
but many places don’t have that resource.
“If parents find out that their kids have asthma symptoms that keep
occurring it is possible that the child is not taking their
medication at all,” Brand said. “If they deny the disease and don’t
take the meds, they will be suffering more.”
Kids might be less likely to use their inhalers in front of friends
because of the social stigma, Ting said, but if they take their
corticosteroid every day it is less likely that they will have to do
that.
With proper medication use, kids should be able to play sports and
activities and be at no increased risk of anxiety or depression, he
said.
SOURCE: http://bit.ly/1m1SKwH Archives of Disease in Childhood,
online May 8, 2014.
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