Chest
Volume 134, Issue 6, December 2008, Pages 1176-1182
Journal home page for Chest

Original Research
Asthma
The Asthma/Mental Health Nexus in a Population-Based Sample of the United States

https://doi.org/10.1378/chest.08-1528Get rights and content

Background

Asthma is one of the most prevalent chronic medical conditions in the United States. The relationship of asthma with psychological factors has been known for centuries, and recently there has been a resurgence of interest in this topic. This study investigates the relationship between current asthma and poor mental health in a nationally representative sample of the US population.

Methods

This study utilizes data from the 2006 Behavioral Risk Factor Surveillance System survey (n = 355,710). A multinomial logistic regression model was constructed to assess the relationship between current asthma and poor mental health. The relationship between formerly having asthma and poor mental health was also investigated.

Results

Persons reporting poor mental health have increased risk of currently having asthma compared to persons reporting good mental health. Additionally, this asthma/mental health relationship has a “dose-response” relationship. For every incremental increase in days of poor mental health, there is a corresponding increase in risk of currently having asthma. Previously reported risk factors for asthma (ie, age, gender, race, marital, smoking, overall health, exercise, obesity, and socioeconomic status) were all found to be important covariates of asthma. The relationship between former asthma and poor mental health is less clear.

Conclusions

This large, nationally representative sample confirms the relationship between asthma and mental health symptoms. Any degree of poor mental health appears to increase one's risk for asthma. Future research is needed to determine the causal and/or physiologic relationship between asthma and mental health symptoms.

Section snippets

Materials and Methods

The Behavioral Risk Factor Surveillance System (BRFSS) is a health-monitoring survey of noninstitutionalized adults administered by telephone at the state level. It is conducted by the Centers for Disease Control and Prevention and since 1994 has been administered annually in all 50 states, Washington, DC; Puerto Rico; the US Virgin Islands; and Guam. Results are weighted accordingly to yield a nationally representative sample of the US population. This study uses data from the 2006 BRFSS

Results

Table 1 presents the results of the bivariate analysis between number of days of poor mental health and the included demographic variables and the final model covariates. Respondents in the oldest age group (> 65 years) consistently were the smallest proportion of respondents in all categories of poor mental health. Women reported significantly worse mental health across all categories. Divorced, separated, and never-married individuals were disproportionately more represented in the poorest

Discussion

There are two major findings of this study. The first is that respondents with any degree of mental health impairment, even those who reported < 14 days of poor mental health, were at increased risk of reporting current asthma. Those reporting ≤ 1 week of poor mental health had an RRR of 1.38 for having asthma, while those reporting 1 to 2 weeks of poor mental health had an RRR of 1.49. The second major finding is that the nexus between mental health impairment and current asthma appears to

References (43)

  • RJ Wright

    Stress and atopic disorders

    J Allergy Clin Immunol

    (2005)
  • EM Andresen et al.

    Performance of health-related quality-of-life instruments in a spinal cord injured population

    Arch Phys Med Rehabil

    (1999)
  • K Toren et al.

    Self-reported asthma was biased in relation to disease severity while reported year of asthma onset was accurate

    J Clin Epidemiol

    (2006)
  • F Rosner

    Moses Maimonides' treatise on asthma

    Thorax

    (1981)
  • W Osler

    The principles and practice of medicine

    (1892)
  • TMAF French

    Psychogenic factors in bronchial asthma

    (1941)
  • AN Ortega et al.

    Childhood asthma, chronic illness, and psychiatric disorders

    J Nerv Ment Dis

    (2002)
  • RD Goodwin et al.

    Mental disorders and asthma in the community

    Arch Gen Psychiatry

    (2003)
  • LP Richardson et al.

    Asthma symptom burden: relationship to asthma severity and anxiety and depression symptoms

    Pediatrics

    (2006)
  • R Lev-Tzion et al.

    Asthma and psychiatric disorders in male army recruits and soldiers

    Isr Med Assoc J

    (2007)
  • RD Goodwin et al.

    A twin study of post-traumatic stress disorder symptoms and asthma

    Am J Respir Crit Care Med

    (2007)
  • Cited by (0)

    The authors have no conflicts of interest to disclose.

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

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