Anxiety disorders and asthma among adolescents in Uganda: role of early-life exposures

Abstract

The reasons for the positive association between anxiety disorders and asthma are unknown. We investigated the possible role of shared exposures in early-life.

We conducted a case-control study among adolescents (12–17 years) with and without asthma in urban Uganda, as part of a larger asthma case-control study. Anxiety disorders were diagnosed by psychiatric clinical officers. We focus on generalised anxiety disorder (GAD), panic disorder and social anxiety disorder. Asthma was doctor-diagnosed by study clinicians. We used questionnaires to collect data on early-life exposures. The data were analysed using multiple logistic regression.

We enrolled 162 adolescents, 73 of them had asthma. Adolescents with asthma were more likely to have any of three anxiety disorders (46.6%) than adolescents without asthma (21.4%) [adjusted odds ratio (AOR) 2.68, 95% confidence interval (CI) 1.30–5.53]. The association was strong for GAD (AOR 4.49, 95% CI 1.48–13.56) and panic disorder (AOR 5.43, 95% CI 2.11–14.02), but not for social anxiety disorder. The early-life risk factors associated with anxiety disorders among adolescents were similar to asthma risk factors previously published, including urban residence at birth [AOR 3.42 (1.29–9.09)] and during most of the first 5 years of life [AOR 2.87 (1.07–7.66)], father's tertiary education [AOR 2.09 (1.00–4.37)], and adolescent's history of other allergy-related diseases [AOR 4.64 (1.66–13.00)].

We confirm a positive association between anxiety disorders and asthma among adolescents in urban Uganda. The early-life risk factors associated with anxiety disorders among adolescents were similar to those for asthma in the same age-group, suggesting shared underlying environmental exposures.