Asthma is the most common chronic illness of childhood and adolescence, and the prevalence rate is increasing. Results from prior studies have suggested an increased prevalence of panic disorder and other anxiety disorders in populations of children and adults with asthma. However, these studies have been limited by having been carried out in tertiary-care settings with small numbers of patients and by a lack of information on the effect of comorbid anxiety and depressive disorders on asthma outcomes. In this epidemiologic study, we propose to (1) compare adolescents with panic disorder and asthma to those with asthma alone in order to measure the impact of panic comorbidity on the personal, familial and societal impacts of asthma such as symptom burden, functional status, quality of life, medical costs and on the quality of asthma self-management; (2) compare adolescents with asthma with one or more anxiety and depressive disorders to adolescents with asthma alone in order to measure the impact of anxiety/depression on the same outcomes as Aim #1. By self-management, we refer to both patients' and providers' roles in ongoing care of a recurrent or chronic illness. These analyses will control for severity of asthma, medical comorbidity and, in Aim #1, psychiatric comorbidity. In addition, two secondary aims include (3) estimating the prevalence of panic disorder and other anxiety and affective disorders in a population-based sample of 1,300 12- to 17-year-olds with asthma enrolled in an HMO and the accuracy of mental health diagnoses and quality of the mental health care provided for these anxiety and depressive disorders; and (4) demonstrating that adolescents with asthma and DSM IV anxiety and/or depressive disorders will have higher parental- and self-ratings of anxiety and depressive symptoms. We anticipate that the results of this study will increase epidemiologic knowledge regarding the effects of comorbid panic disorder and other important anxiety and depressive disorders in adolescents with asthma, and will increase awareness of the impact of these psychiatric disorders on asthma management and outcomes in adolescents. Our research team has over a decade of experience designing population-based intervention studies to improve outcomes for both patients with anxiety and depressive disorders as well as asthma within primary care settings. The results of this grant will be used to develop future treatment programs for adolescent patients with comorbid asthma and anxiety. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH067587-02
Application #
6863732
Study Section
Epidemiology of Clinical Disorders and Aging Study Section (ECDA)
Program Officer
Muehrer, Peter R
Project Start
2004-04-01
Project End
2007-03-31
Budget Start
2005-04-01
Budget End
2006-03-31
Support Year
2
Fiscal Year
2005
Total Cost
$395,807
Indirect Cost
Name
University of Washington
Department
Psychiatry
Type
Schools of Medicine
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
Ludman, Evette J; Russo, Joan E; Katon, Wayne J et al. (2010) How does change in depressive symptomatology influence weight change in patients with diabetes? Observational results from the Pathways longitudinal cohort. J Gerontol A Biol Sci Med Sci 65:93-8
Richardson, Laura P; Russo, Joan E; Lozano, Paula et al. (2010) Factors associated with detection and receipt of treatment for youth with depression and anxiety disorders. Acad Pediatr 10:36-40
Ciechanowski, Paul; Russo, Joan; Katon, Wayne J et al. (2010) Relationship styles and mortality in patients with diabetes. Diabetes Care 33:539-44
Katon, Wayne; Richardson, Laura; Russo, Joan et al. (2010) Depressive symptoms in adolescence: the association with multiple health risk behaviors. Gen Hosp Psychiatry 32:233-9
Katon, Wayne J; Russo, Joan E; Heckbert, Susan R et al. (2010) The relationship between changes in depression symptoms and changes in health risk behaviors in patients with diabetes. Int J Geriatr Psychiatry 25:466-75
Katon, Wayne; Russo, Joan; Lin, Elizabeth H B et al. (2009) Depression and diabetes: factors associated with major depression at five-year follow-up. Psychosomatics 50:570-9
Bennett, Antonia V; Lozano, Paula; Richardson, Laura P et al. (2008) Identifying high-risk asthma with utilization data: a revised HEDIS definition. Am J Manag Care 14:450-6
Richardson, Laura P; Russo, Joan E; Lozano, Paula et al. (2008) The effect of comorbid anxiety and depressive disorders on health care utilization and costs among adolescents with asthma. Gen Hosp Psychiatry 30:398-406
Katon, Wayne; Russo, Joan; Richardson, Laura et al. (2008) Anxiety and depression screening for youth in a primary care population. Ambul Pediatr 8:182-8
Katon, Wayne; Lin, Elizabeth H B; Kroenke, Kurt (2007) The association of depression and anxiety with medical symptom burden in patients with chronic medical illness. Gen Hosp Psychiatry 29:147-55

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