The effect of internalization and other psychologic factors on the remission and severity of wheeze in children

Background Asthma prevalence in Latin America is high and continues to increase. There is evidence that the psychologic characteristics of the child are associated with greater asthma morbidity. This study aimed to investigate the independent effect of internalizing/externalizing problems on two ast...

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Bibliographic Details
Published in:Pediatric allergy and immunology 2016-06, Vol.27 (4), p.398-403
Main Authors: Feitosa, Caroline A., Santos, Darci N., Barreto, Maurício L., Rodrigues, Laura C.
Format: Article
Language:English
Subjects:
Adaptation, Psychological
Age Factors
Asthma
Asthma - diagnosis
Asthma - physiopathology
Asthma - psychology
Asthma and Allergy in Latin America
behavior problems
Brazil
Checklist
Child
Child Behavior
Child, Preschool
childhood asthma
Children & youth
Cost of Illness
Disease Progression
Female
Health risk assessment
Humans
internalization
Logistic Models
Lung - physiopathology
Male
Multivariate Analysis
Odds Ratio
Prospective Studies
remission
Remission Induction
Respiratory Sounds
Risk Factors
severity
Severity of Illness Index
Social Changes
Social Changes, Asthma and Allergy in Latin America
Surveys and Questionnaires
wheeze
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Summary:Background Asthma prevalence in Latin America is high and continues to increase. There is evidence that the psychologic characteristics of the child are associated with greater asthma morbidity. This study aimed to investigate the independent effect of internalizing/externalizing problems on two asthma/wheeze outcomes: (i) remission and (ii) progression to severity on Latin American children with mild asthma symptoms at baseline. Methods This was a prospective study in a cohort of 371 asthmatic children living in a poor urban area in Salvador, Brazil. The psychologic characteristics of the child were assessed using the Child Behavior Checklist (CBCL), and wheezing was defined using the ISAAC questionnaire at the start and end of follow‐up. A multiple logistic regression model with random effects was used to examine the association between the psychologic components and both outcomes. Results Remission of symptoms of wheeze was observed among 229 (61.73%) children. Remission was 56% lower among children with internalizing problems (OR = 0.54, 95% CI 0.33–0.87, p = 0.01). In addition, we found that 19 (8.76%) of the children acquired severe symptoms during follow‐up and there was strong evidence of the effect of internalizing problems in increasing the risk of progression to severe wheeze symptoms (OR = 4.03, 95% CI 1.39–11.70, p = 0.01). Conclusions Children with internalizing problems but not externalizing had less remission of wheezing, and a higher risk of acquiring severe symptoms. These results highlight the importance of psychologic care for children with asthma, to improve the prognosis of this condition.
ISSN:0905-6157
1399-3038
DOI:10.1111/pai.12545