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Article Title

Adolescent Psychiatric Comorbidities Prospectively Predict Greater Asthma-Related Emergency Health Care Visits

Publication Date

8-15-2016

Keywords

adolescent mental health, asthma

Abstract

Background/Aims: Mismanagement of asthma, a prevalent chronic illness in which breathing airways are narrowed, can be life-threatening. Although psychiatric diagnoses are known to hinder self-care, less is known about the individual and combined impact of three relatively common psychiatric diagnoses (i.e. depression, anxiety, attention deficit disorder) on the management of asthma during adolescence, a developmental stage at which risk for psychiatric diagnoses is heightened and enduring health habits are established. The goal of this study was to examine whether the co-occurrence of adolescent psychiatric diagnoses (i.e. comorbidities) interferes with the management of asthma, specifically by contributing to more asthma-related emergency health care visits across three years.

Methods: Health insurance claims records were extracted for a sample of 1,158 adolescents (age 10–19 years; 47% female) diagnosed with asthma who had continuous enrollment across three years in a regional health plan. Diagnostic grouping software identified diagnoses of depression, anxiety and attention deficit disorder as well as their comorbidities. Place of service codes captured asthma-related emergency department and urgent care visits. General linear modeling was used to examine whether psychiatric comorbidities predicted the average number of asthma-related emergency health care visits across three years. Specifically, for the focal independent variable, adolescents were categorized according to the number of psychiatric diagnoses present; for the focal dependent variable, the number of emergency department and urgent care visits were averaged for each month of enrollment across the three study years.

Results: In the comprehensive model, which controlled for potential covariates (i.e. gender, age, SES, months of enrollment), the number of psychiatric comorbidities significantly positively predicted the average number of emergency visits across three years (χ2 = 8.41, P < 0.01).

Conclusion: Adolescents with greater psychiatric comorbidities experienced significantly more asthma-related emergency health care visits over three years. Findings highlight the need to consider the complex interplay between psychological health and chronic illness management during adolescence

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