From:  Biopsychosocial factors, prevention, and treatment strategies in the mental health difficulties of adolescents with asthma

 Characteristics of the main studies on biopsychosocial risk factors.

First author [reference]Participants (n/age range)Main findings
Ciprandi et al. [26]87 AA between 12 and 18 years oldLow scores were found on the resilience scale: 61 in controlled AA, 62 in partially controlled AA, and 60 in uncontrolled AA (p = 0.97).
Castiblanco et al. [27]197 rural adolescents between 12 and 17 years oldAA suffering anxiety had a slightly more than double the risk of being hospitalized in an intensive care unit (OR = 2.09), and an increase of one point on the anxiety scale increased the risk of hospitalization in intensive care for asthma symptoms by 5%.
Nabors et al. [28]20,723 adolescents between 12 and 17 years oldThose with asthma and comorbid anxiety had a higher risk of having low family resilience scores (aOR 1.7 vs. 1.09) and worse health status (aOR 19.6 vs. 3.14) than those with asthma alone.
Licari et al. [29]87 AA between 12 and 18 years oldCompared to the controlled AA, the uncontrolled AA had a significantly higher percentage of elevated anxiety index (p = 0.043) and a higher depression score (p = 0.013).
Patel et al. [30]197 AA between 13 and 19 years oldDepressive symptoms as measured by scales were significantly associated with poor asthma control as measured by ACT (p = 0.001).
Naveen et al. [31]102 AAAA have a higher risk of depression as their adherence to treatment worsened: intermediate adherence (aOR = 7.09, p = 0 0.01), poor adherence (aOR = 9, p = 0.01).
Kosse et al. [32]243 AA between 12 and 18 years oldThe quality of life reported in AA had a good correlation with identity (r = –0.66; p < 0.001), with concern about the disease (r = –0.64; p < 0.001), and emotional representation (r = 0.63; p < 0.001).
Workman et al. [33]1,812 AA between 12 and 17 years oldAA and allergies, behavioral problems, BMI > 85, or moderate to severe asthma had a higher risk of making and maintaining friendships than those without these conditions (OR = 4.71, 4.65, 1.4, and 1.19, respectively). Adolescents whose parents had problems coping with parenting or were exposed to stress were also at greater risk of making and maintaining friendships (OR = 5.72 and 3.6, respectively).
Fruchter et al. [34]296 AA and their parents between 10 and 17 years oldAAs and their parents who reported ADHD symptoms had a greater underperception of asthma symptoms (p = 0.04 and p = 0.02, respectively), as well as maladaptive beliefs regarding asthma (p < 0.001 for both).
Silverstein et al. [35]302 AA between 10 and 17 years oldAA, who had more ADHD symptoms, showed worse adherence to control medication and indirectly had more emergency room visits (p = 0.002 and 0.02, respectively)
Estanislau et al. [36]Data from 59,442 adolescents between 12 and 17 years oldThe prevalence of asthma was higher in adolescents with short nighttime sleep (< 7 hours), common mental disorders, and excess weight (p = 0.03, p < 0.0001, and p = 0.03, respectively).
Evans et al. [37]33 with uncontrolled AA between 12 and 15 years old and their caregivers42% of AA and caregivers reported nighttime symptoms that caused awakenings. Asthma sufferers reported that sleep disturbances are a barrier to asthma self-management. 27% of caregivers reported distress due to their children’s nighttime asthma symptoms.
Azzi et al. [38]202 adolescents between 12 and 18 years oldLiving in a rural area, smoking water pipes, somatic complaints, and behavioral problems were associated with asthma control problems in adolescents (p = 0.018, 0.017, 0.005, and 0.038, respectively).
Dut et al. [39]204 adolescents between 12 and 21 years old and their parentsParental depression and somatization were associated with psychiatric problems in adolescents (p = 0.04 and 0.02, respectively). Parental anxiety, negative parental self-esteem, and parental somatization were associated with somatization in adolescents (p = 0.04, 0.03, and 0.003, respectively).

AA: adolescents with asthma; ACT: asthma control test; ADHD: attention deficit hyperactivity disorder; BMI: body mass index; OR: odds ratio; r: correlation coefficient.