Published online December 1, 2006
PEDIATRICS Vol. 118 No. 6 December 2006, pp. e1715-e1720 (doi:10.1542/10.1542/peds.2006-1119)

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ARTICLE

Psychiatric Symptomatology and Disorders in Caregivers of Children With Asthma

E. Sherwood Brown, MD, PhD^a, Vanthaya Gan, MD^b, Jala Jeffress, BA^a, Kacy Mullen-Gingrich, BA^a, David A. Khan, MD^c, Beatrice L. Wood, PhD^d, Bruce D. Miller, MD^e, Rebecca Gruchalla, MD, PhD^c and A. John Rush, MD^a,f

^a Departments of Psychiatry
^b Pediatrics
^c Internal Medicine
^f Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
^d Departments of Psychiatry and Pediatrics, State University of New York at Buffalo, Buffalo, New York
^e Child and Adolescent Psychiatry, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York

OBJECTIVE. The prevalence of asthma and asthma-related mortality has increased in recent years. Data suggest an association between psychiatric symptoms in the caregiver and asthma-related hospitalizations in the child. We examined the prevalence of psychiatric symptoms and disorders and their relationship to asthma-related service utilization in caregivers of children hospitalized for asthma.

PATIENTS AND METHODS. Caregivers (n = 175) were assessed during the child’s hospitalization. The number of asthma-related hospitalizations, emergency department visits, and unscheduled clinic visits in the past 12 months was obtained. The Brief Symptom Inventory, an assessment of psychiatric symptoms including somatic, anxiety, and depression subscales, and the Mini International Neuropsychiatric Interview, a structured clinical interview for psychiatric disorders, were administered.

RESULTS. Mean age of the caregivers was 34.2 ± 7.3 years; 96.0% were women; 15.4% were white, 57.7% were black, and 26.3% were Hispanic. A total of 47.9% had incomes less than $25000/year. Caregivers with clinically significant elevations in 2 or more Brief Symptom Inventory subscales reported more asthma-related child hospitalizations in the past 12 months than did caregivers with lower Brief Symptom Inventory scores. Asthma-related hospitalizations correlated with Brief Symptom Inventory total, somatic, anxiety, and depression subscale scores. Caregiver diagnosis of an anxiety disorder (n = 36) was associated with more asthma-related hospitalizations in the child. Children of caregivers with current depression (n = 44) had more unscheduled clinic visits than children of caregivers without depression.

CONCLUSION. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition–defined psychiatric disorders, particularly depressive disorders, were common in caregivers and associated with a greater frequency of asthma-related hospitalizations in the child.

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Key Words: asthma • depression • caregiver • child hospitalization • service utilization

Abbreviations: BSI—Brief Symptom Inventory • ED—emergency department • CMCD—Children’s Medical Center of Dallas • IRB—institutional review board • MINI—Mini International Neuropsychiatric Interview • DSM-IV—Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition

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Accepted Aug 3, 2006.

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