Examining impacts of allergic diseases on psychological problems and tobacco use in Korean adolescents: the 2008-2011 Korean National Health and Nutrition Examination Survey

Abstract

Purpose: Asthma during adolescence can induce social, psychological, and behavioral problems. We examined the impact of asthma and other allergic diseases on psychological symptoms and health risk behaviors among South Korean adolescents.

Methods: In this population-based cross-sectional study, 3192 adolescents (10-18 years of age) participating in the 2008-2011 Korean National Health and Nutrition Examination Survey were enrolled. Psychological problems associated with clinically diagnosed asthma, allergic rhinitis, and atopic dermatitis were assessed using questionnaires and surveys. Data was analyzed using logistic regression to determine the association of depression with allergic disease while controlling for age, sex, body mass index, smoking experience, and alcohol use.

Results: Asthma and atopic dermatitis were associated with a higher prevalence of depression (17.2% and 13%, respectively). After adjusting for the covariates, asthma patients were approximately two times as likely to have depression as non-allergic participants (odds ratio, 1.81; 95% confidence interval, 1.22-2.68). Psychosocial stress significantly increased in the following order: no allergy, any allergy without asthma, asthma only, and asthma with any allergy (p for linear trend = 0.01). The asthma without other allergies group showed the highest prevalence of cigarette smoking (p = 0.007).

Conclusions: In this study, asthma with or without other allergies was significantly related to increases in depression, psychosocial stress, and smoking experience. Thus, care should be taken to adjust treatment to account for the psychological symptoms and health risk behaviors common among asthmatic adolescents.

Fig 1. The prevalence of depression and psychological stress among adolescents by allergic disease status.

The error bars represent the upper 95% confidence intervals. The group that includes asthma had a significantly higher prevalence of depression and stress compared to the group that did not include asthma (depression, p for linear trend < 0.001; stress, p for linear trend = 0.01).

Fig 2. The distribution of psychological stress levels among adolescents by allergic disease status.

The group that includes asthma were stressed more frequently than the group that did not include asthma (p for linear trend = 0.03).