There was previously evidence that had shown increased mental health problems such as anxiety, depression and low self esteem among asthmatic children, but now Dutch researchers have demonstrated that children who manage their asthma well are not any more likely to have mental health problems. Most likely the original studies included those patients who did not take their controller medication daily and were not well controlled. When kids take the necessary medicines, they don’t appear to be any worse off psychologically than other children.
In their study, All the children filled out age-appropriate questionnaires meant to assess depression, anxiety and self-esteem. They also answered questions about how well they controlled their wheezing and symptoms.
On the whole, asthmatic kids and their healthy peers scored about the same on the psychological assessments, the authors write in the journal Archives of Disease in Childhood. Between 10 and 20 percent of kids in both groups showed signs of depression, anxiety or low-self esteem.
But kids with poorly controlled asthma tended to score higher on the anxiety questionnaire than kids with well controlled asthma.
“It was sort of common sense that if you are doing well with any kind of chronic illness you won’t have the psychological risks,” Dr. Andrew Ting told Reuters Health by phone.
“If you can work with kids and their parents to agree on daily use of inhaled corticosteroids and appropriate use of rescue medications when necessary, you can really control most asthma,” he said.
A rescue inhaler, like Albuterol, helps to relax the airways during an asthma attack. Children with persistent asthma should also be using a corticosteroid inhaler, like Advair, every day to help reduce airway inflammation and lower mucus levels, he said.
But many children don’t use their daily inhaler, Brand said. “In order to insure adherence, you need to invest in the relationship with kids and their parents,” which is more common in western Europe than in the U.S., he noted.
In order to help children and their families achieve better adherence to their daily medications and better manage their asthma, they can use AsthmaMD mobile App.
“The question is, how do you do that in today’s medical economic climate, how do you carve out the time to make that kind of a relationship with the patients?” Ting said.
It’s impossible to really encourage patients to adhere to a good action plan in a five to ten minute doctor’s visit, he said. At Mount Sinai they have a social worker go over the asthma management plan with patients in more detail outside of a doctor’s appointment, but many places don’t have that resource. Another way would be to use AsthmaMD mobile app, which is the only application that includes an easy to use action plan that is interactive and gives immediate feedback to the patient.
“If parents find out that their kids have asthma symptoms that keep occurring it is possible that the child is not taking their medication at all,” Brand said. “If they deny the disease and don’t take the meds, they will be suffering more.”
Kids might be less likely to use their inhalers in front of friends because of the social stigma, Ting said, but if they take their corticosteroid every day it is less likely that they will have to do that.
With proper medication use, and monitoring using apps like AsthmaMD, kids should be able to play sports and activities and be at no increased risk of anxiety or depression.