Caregiver's depressive symptoms and asthma control in children from an underserved community. (26th November 2017)

• Record Type: Journal Article
• Authors: Rioseco, Andrea; Serrano, Carolina; Celedón, Juan C.; Padilla, Oslando; Puschel, Klaus; Castro-Rodriguez, Jose A.
• Is Part Of: Journal of asthma. Volume 54:Number 10(2017)
• Page Start: 1059
• Page End: 1064
• Publication Date: 2017-11-26
• Subjects: Caregiver depression -- childhood asthma -- cytokines -- cortisol -- immunological dysregulation -- underprivileged population; Asthma -- Periodicals; 616.238005
• DOI: 10.1080/02770903.2017.1292281
• Languages: English
• ISSNs: 0277-0903

Abstract

ABSTRACT: Caregiver's or maternal depression has been associated with increased asthma morbidity in children from prosperous nations, but little is known about this link in low and middle-income countries. Objective: To examine if caregiver's depressive symptoms are associated with poor asthma control and abnormal immune responses in school-aged children. Methods: Case-control study of 87 asthmatic children (aged 4–11 years) attending a primary care clinic in an underserved area of Santiago (Chile). Cases were children with poor asthma control (Child Asthma Control Test [cACT] <20 points) and controls were children with adequate asthma control (cACT ≥20 points). The Beck Depression Inventory-II (BDI) and a locally validated family health vulnerability test (SALUFAM) were used to assess caregivers' depression and family health vulnerability. Serum from participating children was assayed for IFN-γ, IL-4, IL-13, TGF-β, cortisol, and total IgE. Results: The mean (SD) age of study participants was 8.23 (2.15 years), and 55.2% were females. Use of inhaled corticosteroids (ICS), family health vulnerability, and caregiver's depressive symptoms were significantly more common in cases than in controls (65.4% vs. 34.6%, p = 0.003; 41.3% vs. 24.8%, p = 0.07; and 39.1% vs. 19.5%, p = 0.04, respectively). There was no significant difference in the level of any serum biomarkers between groups. In a multivariate analysis, only ICS use was significantly associated with better asthma control (OR = 3.56 [1.34–9.48], p = 0.01). Conclusions: Presence of caregiver's depressive symptoms is associated with poor asthma control among children from an underserved community, but this association was no longer significant after accounting for ICS use.