Elsevier

Ambulatory Pediatrics

Volume 4, Issue 4, July–August 2004, Pages 308-315
Ambulatory Pediatrics

Parental Mental Health, Childhood Psychiatric Disorders, and Asthma Attacks in Island Puerto Rican Youth

https://doi.org/10.1367/A03-169R1.1Get rights and content

Objective.—Previous research documents an association of poor parental mental health with asthma in children. This study aims to determine whether the associations between parental mental health problems and childhood asthma attacks persist after controlling for childhood anxiety and depression and other confounding factors.

Design/Methods.—A community household sample of youth ages 4 to 17 years and their primary caregivers from the US Commonwealth of Puerto Rico was studied to determine the associations between parental mental health and childhood asthma attacks. Regression models that predicted asthma attacks in youth controlled for parental mental health problems, childhood anxiety and depression, zone of residence, and parents' age, education, and perception of poverty.

Results.—After adjusting for children's depressive and anxiety disorders as well as other important confounders, associations between parental depression, suicide attempts, ataque de nervios, and history of mental health treatment and asthma attacks in offspring, by parental report, persisted. Additionally, the frequency of parental mental health problems was associated with children's asthma attacks.

Conclusion.—Parents with mental health problems were more likely to report histories of asthma attacks in their children compared with parents without mental health problems in Puerto Rico. These associations were not attributable to internalizing disorders in youth but persisted independent of childhood psychopathology and other confounding factors. Clinicians and researchers should recognize the relations between poor parental mental health and childhood asthma and explore the potential role of family psychosocial and behavioral factors related to the manifestation of the disease.

Section snippets

METHODS

The “Service Use and Need in Puerto Rican Children” study examined mental health service use and psychiatric disorders for children ages 4 to 17 years in 1998 living in the US Commonwealth of Puerto Rico. The purpose of the original study was to provide data that would guide the integration of epidemiological and mental health service utilization data and to provide an organizational perspective for the study of Puerto Rican children's mental health. The study used two samples. The current

RESULTS

Table 1 shows the results of the differences in subject characteristics by history of childhood asthma attack. Only one marginal significant difference was observed for the characteristics. Children living in urban areas were more likely to have had an asthma attack than those living in rural areas. For the psychiatric disorders, both children with any anxiety disorder and any depressive disorder were more likely to have a history of asthma attack than those with no anxiety or depressive

DISCUSSION

This study has two main findings. First, parental mental health problems and the frequency of problems are associated with increased likelihood of parent-reported asthma attacks in island Puerto Rican youth. Second, a relationship between parental mental health problems and asthma attacks in Puerto Rican youth persists after adjusting for anxiety and depression in youth and other potentially confounding factors.

To our knowledge, this is the first study to examine the associations between

ACKNOWLEDGMENTS

This work was supported by US Public Health Service, National Institute of Mental Health grants R01-MH54827 and P01-MH59876, and by the National Center on Minority Health and Health Disparities grant P20-MD000. The authors thank Mr Pedro Garcia and Dr John Rizzo for help in the analysis of data.

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