Early cigarette smoke, early-onset asthma and exacerbation increases the risk of mental illness during adolescence and early adulthood : A 17-year population-based follow-up study
| Autor: | Wei-Er Wang, 王唯爾 |
|---|---|
| Rok vydání: | 2018 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 106 INTRODUCTIONS: Early onset of asthma among adolescents and young adults not only accounts for high health care use, school absences and loss of work productivity, but impacts mental health, including social relationship and psychiatry problems as well. Previous studies have suggested that cigarette smoke could increase the risk of people suffering from mental illness. We aimed to test the temporal association between asthma and the risk of psychiatic disorder in a large pediatric population and evaluate the interaction between asthma and cigarette smoke on mental illness. Also, we considered the impact of asthma severity on psychiatric disorder. MATERIALS AND METHODS: Data were drawn from an asthma survey implemented in 123 junior high schools in the Kaohsiung and Pingtung regions from 1995-1996, where all students aged 11 to 16 were invited to participate (N=170,457). Each participant and his/her parents finished structured questionnaires. Through linkage with the National Health Insurance Research database, 6,539 people with newly-diagnosed asthma and 143,293 controls were identified between 1999 and 2014. The cohort was followed-up for the incidence of panic, bipolar, anxiety, major depression and any depression disorder to the end of December 31 2015. Cox proportional hazard model was applied, adjusted for gender, age, residence, parent education level, prednisone use, allergic comorbidities, Charlson comorbidity index and cigarette smoking behavior. We defined patients who had been hospitalized or emergency department (ED) visits for asthma as exacerbation status. RESULTS: The median of the follow-up period for various mental disorders in asthma and control groups ranged from 5.65-6.84 years and 7.52-12.48 years respectively. In the fully adjusted Cox model, asthma was associated with greater risk for incident panic disorder (HR: 1.70, 95% CI: 1.28-2.26), bipolar disorder (HR: 1.31, 95% CI: 1.12-1.53) and anxiety disorder (HR: 1.35, 95% CI: 1.15-1.58). Compared to non-smokers non-asthmatic, smokers with early-onset asthma revealed stronger effects on panic, bipolar and anxiety disorder. Mental disorder among asthma patients is partly determined by the poor management of asthma. CONCLUSION: Our results supported the hypothesis that asthma was associated with increased risk for mental illness. The interaction between cigarette smoke and asthma had an elevated risk of developing mental disease, especially in early-onset asthma. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
| Externí odkaz: |
|