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Psychological Adjustment and Asthma in Children and Adolescents: The UK Nationwide Mental Health Survey

From the Academic Division of Clinical Psychology, University of Manchester (R.C., L.G.), UK; and Institute of Psychiatry (R.G.), King’s College London, UK.

Address correspondence and reprint requests to Dr. Rachel Calam, Academic Division of Clinical Psychology, University of Manchester, Second Floor, Education and Research Centre, Wythenshawe Hospital, Manchester M23 9LT, UK. E-mail:Rachel.Calam{at}man.ac.uk

Objective: Data from a nationwide child mental health survey were analyzed to examine relationships between asthma and psychological adjustment.

Methods: Survey design with random selection based on national computer records of 10,438 children aged 5 to 15 from 12,529 eligible families (83%). Strengths and Difficulties Questionnaire (SDQ) was completed by parents, teachers, and 11- to 17-year-olds, providing scores for total difficulties, emotional symptoms, conduct problems, hyperactivity, peer problems, social behavior, and total impact. The Development and Well-Being Assessment (DAWBA) generated ICD-10 diagnoses. Parents reported physical disorders and disabilities, other child mental health risk factors, and rated child’s general level of health.

Results: Children with organic conditions other than asthma were excluded, leaving 9,834 children, 49.9% male. Preliminary comparisons indicated higher parent and teacher rated scores for children with asthma. New variables combined asthma and general health to produce four groups. Logistic regressions were conducted with children without asthma and in good health as the reference group. Children with asthma in good health showed greater parent-rated emotional problems, but otherwise, few elevated odds ratios. Children without asthma in poor health were at significantly greater risk of disorder, as were children with asthma in poor health. Findings on ratings of hyperactivity are discussed.

Conclusion: Findings that children with asthma have elevated psychological difficulties may result from poor health rather than asthma itself.

Key Words: asthma • adaptation–psychological • child behavior

Abbreviations: SDQ = Strengths and Difficulties Questionnaire; DAWBA = Development and Well-Being Assessment.

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