Allergy Asthma Immunol Res.  2013 Sep;5(5):315-321. 10.4168/aair.2013.5.5.315.

Allergic Diseases in Preschoolers Are Associated With Psychological and Behavioural Problems

Affiliations
  • 1Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. sjhong@amc.seoul.kr
  • 2Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea.
  • 3Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sjhong@amc.seoul.kr
  • 4Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 5Department of Pediatrics, Hae-undae Paik Hospital, Inje University College of Medicine, Busan, Korea.
  • 6Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
  • 7Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea.
  • 8Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Ilsan, Korea.
  • 9Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea.
  • 10Department of Pediatrics, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
  • 11Department of Pediatrics, Kangbuk Samsung Hospital, Sunkyunkwan University College of Medicine, Seoul, Korea.
  • 12Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea.
  • 13Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 14Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 15Center for Immunology & Pathology, Korea National Institute of Health, Chungcheongbuk-do, Korea.

Abstract

PURPOSE
The aim of the present study was to investigate the relationship between three major allergic diseases, asthma, allergic rhinitis (AR), and atopic dermatitis (AD), and psychological and behavioural problems in preschoolers based on a community survey.
METHODS
A cross-sectional survey was conducted using a modified International Study of Asthma and Allergies in Childhood questionnaire to determine the prevalence of symptoms and diagnosed allergic diseases, and a Korean version of the Child Behaviour Checklist to assess internalizing, externalizing, and sleep problems among 780 preschoolers. Five-hundred and seventy-five preschoolers with valid data were included in this study.
RESULTS
The prevalence of lifetime diagnosis and treatment in the past 12 months was 8.7% and 4.4% for asthma, 24.4% and 19.2% for AR, and 35.1% and 16.6% for AD, respectively. Scores for internalizing and sleep problems were significantly higher in those diagnosed with AR. Preschoolers who had been treated for AD in the past 12 months had higher attention problem and attention-deficit/hyperactivity disorder scores. Sleep problems were more severe in moderate to severe AD compared to control and mild AD groups, categorised according to SCOring index of AD. The severity of sleep problems correlated positively with the percentage of eosinophils in peripheral blood.
CONCLUSIONS
Psychological and behavioural problems differed among the three major allergic diseases, weaker association for asthma and stronger association for AR and AD. The results of this study may lead to the identification of potential underlying shared mechanisms common to allergic diseases and psychological and behavioural problems.

Keyword

Preschool child; psychometrics; asthma; allergic rhinitis; atopic dermatitis

MeSH Terms

Asthma
Checklist
Child
Child, Preschool
Cross-Sectional Studies
Dermatitis, Atopic
Eosinophils
Humans
Hypersensitivity
Prevalence
Psychometrics
Rhinitis
Rhinitis, Allergic, Perennial
Surveys and Questionnaires

Cited by  2 articles

Research on pediatric allergic rhinitis in Korea
Kyung Suk Lee, Yeong Ho Rha
Allergy Asthma Respir Dis. 2018;6(Suppl 1):S58-S65.    doi: 10.4168/aard.2018.6.S1.S58.

Behavioral characteristics and parental stress in elementary school children with bronchial asthma and allergic rhinitis
Eunjeong Choi, Mi Ji Lee, Hyun-Jin Yun, Ja Hyeong Kim, Ju Suk Lee, Jae Hong Park, Jin-A Jung
Allergy Asthma Respir Dis. 2016;4(3):205-211.    doi: 10.4168/aard.2016.4.3.205.


Reference

1. Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, Williams H. ISAAC Phase Three Study Group. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet. 2006; 368:733–743.
2. O'Connell EJ. The burden of atopy and asthma in children. Allergy. 2004; 59:Suppl 78. 7–11.
3. Hong SJ, Lee MS, Sohn MH, Shim JY, Han YS, Park KS, Ahn YM, Son BK, Lee HB. Korean ISAAC Study Group. Self-reported prevalence and risk factors of asthma among Korean adolescents: 5-year follow-up study, 1995-2000. Clin Exp Allergy. 2004; 34:1556–1562.
4. Cho SH, Park HW, Rosenberg DM. The current status of asthma in Korea. J Korean Med Sci. 2006; 21:181–187.
5. Rowe AH. Allergic toxemia and migraine due to food allergy: report of cases. Cal West Med. 1930; 33:785–793.
6. Freud S. Inhibitions, symptoms and anxiety. London: Hogarth Press;1959.
7. Anandan C, Sheikh A. Preventing development of allergic disorders in children. BMJ. 2006; 333:485.
8. Wright RJ, Cohen RT, Cohen S. The impact of stress on the development and expression of atopy. Curr Opin Allergy Clin Immunol. 2005; 5:23–29.
9. Wright RJ, Rodriguez M, Cohen S. Review of psychosocial stress and asthma: an integrated biopsychosocial approach. Thorax. 1998; 53:1066–1074.
10. Slattery MJ, Essex MJ. Specificity in the association of anxiety, depression, and atopic disorders in a community sample of adolescents. J Psychiatr Res. 2011; 45:788–795.
11. Park J, Kim BJ, Kwon JW, Song YH, Yu J, Kim HB, Lee SY, Kim WK, Jee HM, Kim KW, Kim KE, Hong SJ, Shin YJ. Patterns of psychosocial adaptation and allergic disorders in Korean schoolchildren. Int Arch Allergy Immunol. 2011; 154:249–257.
12. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet. 1998; 351:1225–1232.
13. Oh KJ, Lee H, Hong KE, Ha EH. Manual for the Korean child behavior checklist. Seoul: Joongang Jeokseong Press;1997.
14. Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European Task Force on Atopic Dermatitis. Dermatology. 1993; 186:23–31.
15. Oranje AP, Glazenburg EJ, Wolkerstorfer A, de Waard-van der Spek FB. Practical issues on interpretation of scoring atopic dermatitis: the SCORAD index, objective SCORAD and the three-item severity score. Br J Dermatol. 2007; 157:645–648.
16. Achenbach TM. Manual for the child behavior checklist/4-18 and 1991 profile. Burlington, VT: Department of Psychiatry, University of Vermont;1991.
17. Achenbach TM, Edelbrock C. Manual for the child behavior checklist and revised child behavior profile. Burlington, VT: Department of Psychiatry, University of Vermont;1993.
18. Ha EH, Oh KJ. Standardization of K-CBCL: analysis of validity and reliabiltiy. Seoul: Korean Clinical Psychology Association;1997.
19. Addolorato G, Ancona C, Capristo E, Graziosetto R, Di Rienzo L, Maurizi M, Gasbarrini G. State and trait anxiety in women affected by allergic and vasomotor rhinitis. J Psychosom Res. 1999; 46:283–289.
20. Cuffel B, Wamboldt M, Borish L, Kennedy S, Crystal-Peters J. Economic consequences of comorbid depression, anxiety, and allergic rhinitis. Psychosomatics. 1999; 40:491–496.
21. Marshall PS, O'Hara C, Steinberg P. Effects of seasonal allergic rhinitis on fatigue levels and mood. Psychosom Med. 2002; 64:684–691.
22. Blaiss MS. Pediatric allergic rhinitis: physical and mental complications. Allergy Asthma Proc. 2008; 29:1–6.
23. Santos CB, Pratt EL, Hanks C, McCann J, Craig TJ. Allergic rhinitis and its effect on sleep, fatigue, and daytime somnolence. Ann Allergy Asthma Immunol. 2006; 97:579–586.
24. Léger D, Annesi-Maesano I, Carat F, Rugina M, Chanal I, Pribil C, El Hasnaoui A, Bousquet J. Allergic rhinitis and its consequences on quality of sleep: an unexplored area. Arch Intern Med. 2006; 166:1744–1748.
25. Juniper EF, Guyatt GH, Dolovich J. Assessment of quality of life in adolescents with allergic rhinoconjunctivitis: development and testing of a questionnaire for clinical trials. J Allergy Clin Immunol. 1994; 93:413–423.
26. McQuaid EL, Kopel SJ, Nassau JH. Behavioral adjustment in children with asthma: a meta-analysis. J Dev Behav Pediatr. 2001; 22:430–439.
27. Alati R, O'Callaghan M, Najman JM, Williams GM, Bor W, Lawlor DA. Asthma and internalizing behavior problems in adolescence: a longitudinal study. Psychosom Med. 2005; 67:462–470.
28. Klinnert MD, Nelson HS, Price MR, Adinoff AD, Leung DY, Mrazek DA. Onset and persistence of childhood asthma: predictors from infancy. Pediatrics. 2001; 108:E69.
29. Beyreiss J, Roth N, Beyer H, Kropf S, Shlenzka K, Schmidt A, Roscher G. Coincidence of immune (atopic dermatitis) and behavioral (attention deficit) disorders in children: empirical data. Act Nerv Super (Praha). 1988; 30:127–128.
30. Roth N, Beyreiss J, Schlenzka K, Beyer H. Coincidence of attention deficit disorder and atopic disorders in children: empirical findings and hypothetical background. J Abnorm Child Psychol. 1991; 19:1–13.
31. Blank R, Remschmidt H. Hyperkinetic syndrome: the role of allergy among psychological and neurological factors. Eur Child Adolesc Psychiatry. 1994; 3:220–228.
32. Daud LR, Garralda ME, David TJ. Psychosocial adjustment in preschool children with atopic eczema. Arch Dis Child. 1993; 69:670–676.
33. Gaitens T, Kaplan BJ, Freigang B. Absence of an association between IgE-mediated atopic responsiveness and ADHD symptomatology. J Child Psychol Psychiatry. 1998; 39:427–431.
34. Mitchell EA, Aman MG, Turbott SH, Manku M. Clinical characteristics and serum essential fatty acid levels in hyperactive children. Clin Pediatr (Phila). 1987; 26:406–411.
35. Bender BG, Ballard R, Canono B, Murphy JR, Leung DY. Disease severity, scratching, and sleep quality in patients with atopic dermatitis. J Am Acad Dermatol. 2008; 58:415–420.
36. Bender BG, Leung DY. Sleep disorders in patients with asthma, atopic dermatitis, and allergic rhinitis. J Allergy Clin Immunol. 2005; 116:1200–1201.
37. Reuveni H, Chapnick G, Tal A, Tarasiuk A. Sleep fragmentation in children with atopic dermatitis. Arch Pediatr Adolesc Med. 1999; 153:249–253.
38. Hon KL, Leung TF, Wong Y, Fok TF. Lesson from performing SCORADs in children with atopic dermatitis: subjective symptoms do not correlate well with disease extent or intensity. Int J Dermatol. 2006; 45:728–730.
39. Chida Y, Hamer M, Steptoe A. A bidirectional relationship between psychosocial factors and atopic disorders: a systematic review and meta-analysis. Psychosom Med. 2008; 70:102–116.
Full Text Links
  • AAIR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr