Depressive Symptoms in Inner-City Children With Asthma

Kristine M. Morrison, M.A.; Arezou Goli, M.D.; John Van Wagoner, M.D.; E. Sherwood Brown, Ph.D., M.D.; and David A. Khan, M.D.

Background: Asthma is a sometimes severe respiratory illness with an increased prevalence, especially in low-income, minority, and inner- city populations, over the past 2 decades. Prior reports have suggested a link between depression and asthma deaths. However, no studies have examined the relationship between objective measures of asthma severity and clinician-rated depressive symptom severity.

Method: In this pilot study, 46 children receiving treatment at an inner-city asthma clinic were assessed with the Children's Depression Rating Scale, Revised (CDRS-R). The current percentage of forced expiratory volume in 1 second (FEV₁%) predicted and the inhaled steroid dose were recorded, as were oral steroid use, emergency room visits, and hospitalizations in the preceding year.

Results: Depressive symptoms were common in this sample, with 30% (N = 14) of the participants having CDRS-R scores consistent with likely, very likely, or almost certain major depressive disorder. When mean CDRS-R scores were compared between the sample divided by these asthma severity measures, only hospitalizations in the past year was associated with higher depressive symptom scores (p = .03).

Conclusion: These findings suggest that in the patient sample studied, depressive symptoms appear to be common. However, depressive symptom severity is related only to hospitalization, not other measures of asthma severity. Larger studies are needed to confirm these findings and determine if other variables such as family history of depression or subjective assessment of asthma severity explain the high prevalence of depressive symptoms in these patients.

(Primary Care Companion J Clin Psychiatry 2002;4:174-177)

Received Sept. 8, 2002; accepted Nov. 6, 2002. From the Science Teacher Access to Resources at Southwestern (STARS) Program (Ms. Morrison) and the Departments of Internal Medicine (Drs. Goli, Van Wagoner, and Khan) and Psychiatry (Dr. Brown), University of Texas Southwestern Medical Center, Dallas.

The authors report no financial affiliation or other relationship relevant to the subject matter of this article.

Corresponding author and reprints: E. Sherwood Brown, Ph.D., M.D., Department of Psychiatry, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75390-8849 (e-mail: Sherwood.Brown@UTSouthwestern.edu).