Depressive Symptom Trajectories Across Adolescence and Adulthood Among Individuals With Asthma
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Abstract Objective Individuals with asthma experience increased depressive symptoms, which is associated with deleterious health outcomes. No studies have examined depressive symptom trajectories among individuals with asthma despite increased risk. This study expanded prior literature by identifying the following: (1) depressive symptoms trajectories for individuals with and without asthma and (2) predictors of baseline levels and changes in symptoms across time for individuals with asthma. Methods Adolescents with (N = 965) and without (N = 7,392) asthma self-reported on depressive symptoms (CESD-9) across development. Covariates included: demographics and persistence of asthma. Latent growth curve modeling (LGCM) was used to identify depressive symptom trajectories and their predictors. Results A multigroup LCGM identified no significant differences between depressive symptom trajectories of individuals with and without asthma. Depressive symptoms followed a quadratic shape across time for individuals with asthma (Mintercept = 5.73, p < .00; Mlinear = −0.38,p < .001; Mquad = 0.03, p < .001), with a linear deceleration in depressive symptoms during adolescence and an acceleration of symptoms into adulthood. Next predictors of depressive trajectories among individuals with asthma were examined. Female sex (B = 0.58, p < .001), lower parent education (B = −0.57, p < .001), older age (B = 0.19, p < .001), and identifying as Black (B = 0.31, p = .04) were associated with greater baseline depressive symptoms. Older individuals exhibited faster linear symptom decelerations (B = −0.56, p < .001) and faster symptom accelerations (B = 0.73, p < .001). American Indian (AIAN) individuals exhibited faster linear symptom decelerations (B = −1.98, p = .005) and faster quadratic accelerations (B = 3.33, p = .007). Discussion Our results suggest that the depressive symptom trajectories of individuals with asthma are curvilinear and similar to individuals without asthma. When examining predictors of depressive symptom trajectories for those with asthma, socioeconomic disadvantage and racial marginalization were associated with greater baseline depressive symptoms. Although AIAN youth demonstrated more favorable trajectories in adolescence, they also exhibited worse trajectories across young adulthood and adulthood. Findings suggest the need to better understand the impact of multilevel risk and protective factors on depressive symptoms trajectories for individuals with asthma, especially marginalized populations.Cite
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(1956). Medihaler® Therapy for Bronchial Asthma. Postgraduate Medicine: Vol. 20, No. 6, pp. 667-673.
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Asthma management
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To the Editor:—
I read the paper entitled "Bronchial Asthma as a Complication of Pregnancy" by Dr. Bradford Green (The Journal, February, 3, p. 360) and also the communication in Correspondence (April 14, p. 1248) from Dr. R. H. Kampmeier, and would like to comment on Dr. Kampmeier's letter. His contention that allergic manifestations disappear during pregnancy, in contradiction to Dr. Green's experience that there is aggravation of asthma during pregnancy, is also borne out by my experience of an interesting case. A woman, aged 28, had had severe attacks of bronchial asthma for the past eight years. During pregnancy she was free of all symptoms of asthma and this absence of symptoms continued till three weeks post partum. When she was 30, I delivered her of her eighth child. All lived. The pregnancies occurred about one year apart to relieve her of her asthma. All the customary skin testingPost partum
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Asthma mortality rates have been increasing since 1979, but rates of change among different demographic subgroups have not been examined in detail. This analysis identifies the demographic subgroups that are most responsible for the increase in asthma mortality rates in the United States between 1979 and 1996. The analysis is limited to those death certificates that specified asthma as the underlying cause of death. Blacks, females, and people aged 65 and older had the largest increases in age-adjusted asthma mortality rates between 1979 and 1996. When all three demographic variables are considered simultaneously, black females aged 65 years and older had the highest crude asthma mortality rates in 1996 and the largest increase in rates since 1979. However, white females aged 65 years and older contributed the most to the increase in age-adjusted rates between 1979 and 1996 because of their relatively larger population size. Overall, the increase in asthma mortality rates between 1979 and 1996 was due primarily to increased mortality rates in the population subgroup aged 65 years and older Even though the rapid increase in asthma mortality rates in those aged 65 years and older shows evidence of a slight reversal after 1989, efforts to develop strategies to reduce overall mortality from asthma should concentrate on middle-aged and elderly women.
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Recent advances in our knowledge of human sensitization to foreign proteins have opened numerous avenues of approach to the studies of symptom-complexes such as asthma, vasomotor rhinitis and obscure gastrointestinal disorders, as well as cutaneous manifestations of the type of angioneurotic edema, urticaria, and eczema. That these conditions are not infrequently external evidences of cellular disturbances dependent on a varied protein intoxication is now generally conceded. That the mechanism of such disturbance differs, however, from the usual immunologic processes as seen in anaphylaxis and infections is evidenced by the attempts, unsuccessful, with few exceptions, to demonstrate experimentally antibody formation to the foreign proteins by the usual laboratory methods. These peculiar states of hypersensitiveness have been characterized as "allergy," a term first applied by von Pirquet,1and recently "atopy" by Coca and Cooke.2 One of the most important of this group of diseases, asthma, has confused medical literature a
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Laryngeal Edema
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Bronchial asthma is an important cause of morbidity and mortality worldwide. There is limited availability of updated information on asthma mortality trends. In this context, further investigation of asthma mortality trends is necessary.We aimed to assess trends in asthma mortality trends in the Autonomous Community of Andalusia (over 7 million inhabitants), Spain, during the period 1975-2005.Official population estimates and data on asthma deaths were obtained from official authorities. Crude and age-adjusted death rates for different age and gender groups were calculated. Joinpoint regression analysis was used for trend analysis.Age-adjusted death rates for asthma have fallen 2.9% for females and 7.7% for males from 1975 to 2005. This trend has not been constant but has varied during the study period. After a non-significant increase from 1975 to 1981 (4.5% for females and 3.8% for males), adjusted asthma mortality rates have been declining 3.7% for females and 9.6% for males (both p values < 0.05) since 1981. Age-group analysis revealed that the downturn in asthma mortality rates occurred in all age groups above 45 years for males and 35 years for females.During the last decades, significant variation in asthma mortality was found in Andalusia. This variation has not been constant during the study period. Currently, the decreasing trend initiated in 1981 continues.
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