Comorbid Anxiety Disorders in Adolescents with Asthma

描述（由研究者提供）：哮喘是儿童和青少年最常见的慢性疾病，患病率呈上升趋势。先前的研究结果表明，在患有哮喘的儿童和成人人群中，恐慌症和其他焦虑症的患病率有所增加。然而，由于这些研究是在三级医疗机构中进行的，患者数量较少，并且缺乏关于共病性焦虑和抑郁障碍对哮喘结局的影响的信息，这些研究受到了限制。在这项流行病学研究中，我们建议(1)比较惊恐障碍合并哮喘的青少年与单独哮喘的青少年，以衡量惊恐合并症对哮喘的个人、家庭和社会影响，如症状负担、功能状态、生活质量、医疗费用和哮喘自我管理质量的影响；(2)比较哮喘青少年合并一种或多种焦虑和抑郁障碍与单独哮喘青少年，以衡量焦虑/抑郁对与目标1相同的结果的影响。通过自我管理，我们指的是患者和提供者在经常性或慢性疾病的持续护理中的角色。这些分析将控制哮喘的严重程度、医学合并症以及Aim #1中的精神合并症。此外，两个次要目的包括(3)估计在HMO登记的1300名12- 17岁哮喘患者中惊恐障碍和其他焦虑和情感障碍的患病率，以及为这些焦虑和抑郁障碍提供的心理健康诊断的准确性和精神卫生保健的质量；(4)证明患有哮喘和DSM IV焦虑症和/或抑郁症的青少年将有更高的父母和自评焦虑和抑郁症状。我们预计，本研究的结果将增加关于共病性惊恐障碍和其他重要的焦虑和抑郁障碍在青少年哮喘患者中的影响的流行病学知识，并将增加对这些精神障碍对青少年哮喘管理和结局的影响的认识。我们的研究团队在设计基于人群的干预研究方面有超过十年的经验，以改善初级保健机构中焦虑、抑郁障碍和哮喘患者的预后。这笔拨款的结果将用于开发未来的治疗方案，青少年患者的共病哮喘和焦虑。

DESCRIPTION (provided by investigator): Asthma is the most common chronic illness of childhood and adolescence, and the prevalence rate is increasing. Results from prior studies have suggested an increased prevalence of panic disorder and other anxiety disorders in populations of children and adults with asthma. However, these studies have been limited by having been carried out in tertiary-care settings with small numbers of patients and by a lack of information on the effect of comorbid anxiety and depressive disorders on asthma outcomes. In this epidemiologic study, we propose to (1) compare adolescents with panic disorder and asthma to those with asthma alone in order to measure the impact of panic comorbidity on the personal, familial and societal impacts of asthma such as symptom burden, functional status, quality of life, medical costs and on the quality of asthma self-management; (2) compare adolescents with asthma with one or more anxiety and depressive disorders to adolescents with asthma alone in order to measure the impact of anxiety/depression on the same outcomes as Aim #1. By self-management, we refer to both patients' and providers' roles in ongoing care of a recurrent or chronic illness. These analyses will control for severity of asthma, medical comorbidity and, in Aim #1, psychiatric comorbidity. In addition, two secondary aims include (3) estimating the prevalence of panic disorder and other anxiety and affective disorders in a population-based sample of 1,300 12- to 17-year-olds with asthma enrolled in an HMO and the accuracy of mental health diagnoses and quality of the mental health care provided for these anxiety and depressive disorders; and (4) demonstrating that adolescents with asthma and DSM IV anxiety and/or depressive disorders will have higher parental- and self-ratings of anxiety and depressive symptoms. We anticipate that the results of this study will increase epidemiologic knowledge regarding the effects of comorbid panic disorder and other important anxiety and depressive disorders in adolescents with asthma, and will increase awareness of the impact of these psychiatric disorders on asthma management and outcomes in adolescents. Our research team has over a decade of experience designing population-based intervention studies to improve outcomes for both patients with anxiety and depressive disorders as well as asthma within primary care settings. The results of this grant will be used to develop future treatment programs for adolescent patients with comorbid asthma and anxiety.