Exploring the relationship between asthma, its severity and anxiety symptoms in pediatric patients: a case-control study

Abstract

Background

Asthma is a global health concern, especially among children, and is associated with various underlying mechanisms. Childhood exposure to early life stress and anxiety can potentially exacerbate asthma symptoms and complicate its management. While some studies have suggested the benefits of psychological therapies as adjuncts to medication in asthma management, evidence remains inconsistent, emphasizing the need for rigorous evaluation.

Method

This case-control study involved 120 children aged 5–15, with 60 children having asthma and 60 healthy controls. Asthma severity was assessed based on EPR3 guidelines, while anxiety symptoms were measured using the Spence Children’s Anxiety Scale (SCAS). Demographic data and asthma-related information were collected via questionnaires. Statistical analyses were conducted to explore the relationship between asthma and anxiety.

Results

Children with asthma exhibited significantly higher anxiety symptoms compared to those without asthma (p < 0.001). Subdomain analysis revealed elevated scores in separation anxiety (SA; p = 0.025), social phobia (SP; p < 0.001), agoraphobia (p = 0.004), and fears of physical injury (p < 0.001) in children with asthma. Furthermore, increased need for SABA, frequency of nocturnal symptoms, and asthma severity were associated with higher anxiety levels in pediatric asthma patients.

Conclusions

This study highlights a significant association between asthma and heightened anxiety symptoms in children, particularly in domains, such as SA, SP, agoraphobia, and fears related to physical injury. However, limitations include reliance on self-evaluation questionnaires and the observational nature of the study, emphasizing the need for cautious interpretation.

Keywords:

• Asthma
• children
• anxiety

Author contributions

M.S., A.A., and M.Z. designed the study protocol. A.P. was the board-certified pediatric allergist and clinical immunologist who recruited the participants. M.S. was responsible for data collection. A.T. performed the statistical analysis and drafted the tables and figures. A.T. and Y.G. wrote the first draft of the manuscript and T.E., M.Z., A.A., and A.P. helped with the revision of the manuscript. All authors approved the conclusions of our study.

Declaration of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to Ethical restrictions that could compromise the privacy of research participants.

Additional information

Funding

The study was supported by the Arak University of Medical Sciences, Arak, Iran, Islamic Republic of. ID: 6737.