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Eotional and behavioural problems in Swedish 7-to 9-year olds with asthma

The Nordic School of Public Health and the Vardal Institute, Lund and Goteborg University, Sweden; The Nordic School of Public Health,PO Box 12133, SE-402 42 Goteborg, Sweden kjell%reichenberg.se

A G Broberg

Department of Psychology, Goteborg University, Sweden

Background: The purpose of this study is to compare emotional and behavioural problems between preadolescent children with asthma and healthy children, and to explore if disease factors relate to problem scores. Design: This was a cross-sectional study of 59 children, 34 boys and 25 girls, aged 7-9 years with mild (n = 11), moderate (n = 38) or severe (n = 10) asthma. A normative sample of 306 children in the same age range, 150 boys and 156 girls, was used as a comparison group.Methods: Parents assessed emotional and behavioural problems using the Child Behaviour Checklist. Peak expiratory flow rate and urinary eosinophil protein X were used as measures of lung function and inflammation. Children were interviewed about activity restriction and symptoms during the last week using the Paediatric Asthma Quality of Life Questionnaire. Parents scored day,night and exercise-induced symptoms during the same week. Results: On average, children with asthma were attributed more problems than healthy children of the same age and comparable family socio-economic status. Effect sizes were 0.80 (95% confidence interval 0.52-1.09) for total problems, 0.89 (0.60-1.18) for internalizing problems and 0.67 (0.38-0.95) for externalizing problems. The relative risk for children with asthma exceeding the 95% cut-offpoint for total problems was 4.2 (2.1-8.3) compared to healthy children. Conclusion: Children with parent-reported exercise-induced asthma symptoms were attributed more total problems than asthmatic children without such symptoms. Parent-reported day symptoms and child report of symptoms and restricted activities related with problem scores to a lesser degree. Objective measures of lung function and inflammation were not related to problem scores. Concurrent eczema increased problem scores. It is concluded that asthma in preadolescent children is associated with emotional and behavioural problems. Special attention should be paid to children reported to have exercise-induced symptoms.

Key Words: asthma • behavioural problems • children • emotional problems • exercise-induced asthma • psychological adjustment

Chronic Respiratory Disease, Vol. 1, No. 4, 183-189 (2004)
DOI: 10.1191/1479972304cd041oa


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