Asthma, atopy and serious psychological distress: prevalence and risk factors among young people in the Melbourne atopy cohort study

Abstract

Background: While atopic conditions are associated with increased risk of mental health problems, the evidence that a range of allergic conditions are associated with psychological distress in young people is less clear.

Methods: We recruited a longitudinal birth cohort study of 620 children with a family history of allergic disease. At the 18-year follow up, atopic sensitization was determined by skin prick testing. Surveys were used to determine psychological distress (Kessler 6), quality of life (SF12), respiratory symptoms and management, presence of current eczema and hay fever. Regression models were used to identify predictors of psychological distress and quality of life, while controlling for potential confounders.

Results: Prevalence of serious psychological distress was quite low (n = 22, 5.3%), and there were no associations between psychological distress and current atopic sensitization, symptoms of hay fever, eczema or asthma. Smoking status and lower level of maternal education were associated with lower physical quality of life (SF12 PCS subscale). Psychological distress total score, lower maternal education, smoking, female sex, and current eczema were associated with worse mental quality of life (SF12 MCS subscale).

Conclusion: We found relatively low levels of psychological distress in this cohort of young adults, despite a high prevalence of allergic diseases. Positive social factors may serve to buffer psychological distress amongst the cohort accounting for the low prevalence of serious psychological distress observed.

Keywords:

• Epidemiology
• quality of life
• psychological distress

Acknowledgements

We thank Dr John Thorburn, FRACP, for assistance in patient recruitment and administrative assistance and the Mercy Maternity Hospital Department of Obstetrics for participant recruitment, and Dr David Hill and Dr Cliff Hosking for study leadership up to the 12 year follow-up. We thank Anne Balloch for assistance with data management, Rida Asif, Carlie Dunford and Brittany Campbell for project coordination, and Jeeva Sanjeevan for clinical testing during the 18 year follow-up. Most importantly, we thank all of the MACS children and parents for their participation and ongoing support for this study.

Declaration of interests

MA holds investigator initiated grants from Pfizer and Boehringer-Ingelheim for unrelated research. He has received assistance with conference attendance from and undertaken an unrelated consultancy for Sanofi. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

The first 6 years of the MACS was funded (study formula and staff) by Nestec Ltd, a subsidiary of Nestlé Australia. The National Health and Medical Research Council of Australia funded the 18 year follow-up (APP454856). All bodies that have funded aspects of the MACS have had no role in interpretation and publication of study findings.