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. 2025 Jul;36(7):e70151.
doi: 10.1111/pai.70151.

Prospective association between psychopathological symptoms in childhood and asthma in adolescence: Results from the GINIplus and LISA birth cohort studies

Pia-Marie Keim  1 , Ellen Greimel  1   2 , Lisa Feldmann  1   2 , Charlotte Elisabeth Piechaczek  1 , Carla P Harris  3   4 , Claudia Flexeder  4   5   6 , Dietrich Berdel  7 , Andrea von Berg  7 , Sibylle Koletzko  3   8 , Carl-Peter Bauer  9 , Tamara Schikowski  10 , Gunda Herberth  11 , Joachim Heinrich  5   6   12 , Gerd Schulte-Körne  1   2 , Marie Standl  4   6   13
Affiliations

Prospective association between psychopathological symptoms in childhood and asthma in adolescence: Results from the GINIplus and LISA birth cohort studies

Pia-Marie Keim et al. Pediatr Allergy Immunol. 2025 Jul.

Abstract

Background: Although there is a high co-occurrence of psychopathological symptoms and asthma, longitudinal studies considering asthma endotypes in childhood and adolescence are scarce. Therefore, this study examined the prospective association between psychopathology in childhood and current atopic and non-atopic asthma in adolescents, considering sex and puberty-related characteristics.

Methods: The study includes 3584 participants (1790 females, 1794 males) from two German birth cohort studies, GINIplus and LISA. Psychopathological symptoms at age 10 (M = 10.06, SD = .22) were assessed by parent-reported Strengths and Difficulties Questionnaire (SDQ) and current asthma at age 15 (M = 15.07, SD = .30) was defined as a positive parent-reported medical diagnosis, wheezing, and/or medical treatment against asthma (at least two criteria). Atopic asthma was characterized as current asthma and a positive specific immunoglobulin E (IgE) test (≥0.35 kU/L), non-atopic asthma as current asthma without sensitization. Data were analyzed by logistic regression and multinomial regression models, controlling for potential covariates and confounders.

Results: Psychopathological symptoms at age 10 were associated with asthma at age 15 (odds ratio (OR) = 1.69, 95% confidence interval (CI) = 1.04-2.92, p = .035). When examining the endotypes, this effect was replicated only for non-atopic asthma at age 15 (relative risk ratio (RRR) = 2.92, 95% CI = 1.13-7.60, p = .028), but not for atopic asthma (p = .381). Regarding the SDQ subscales, an association between peer problems at age 10 and atopic asthma at age 15 was revealed (RRR = 2.00, 95% CI 1.01-3.97, p = .048). Furthermore, significant interaction effects of puberty onset with psychopathological symptoms (p = .020), and particularly with peer problems (p = .029), were found on atopic asthma.

Conclusion: The findings highlight the importance of early recognition and treatment of psychopathological symptoms to prevent and reduce development, persistence and exacerbation of asthma endotypes, and point to the necessity for further research into hormonal mechanisms linking psychopathology with atopy.

Keywords: Strengths and Difficulties Questionnaire; asthma; epidemiology; psychopathological symptoms; puberty; sex difference.

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Conflict of interest statement

The authors declare none.

Figures

FIGURE 1
FIGURE 1
Derivation of analysis population.
FIGURE 2
FIGURE 2
Significant Results of adjusted multinomial logistic regression analysis including the interaction term of SDQ (subscales), pubertal status at age 10 on atopic asthma at age 15 years.
See this image and copyright information in PMC

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