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Association of atopic and non-atopic asthma with emotional symptoms in school children



Gabriele Kohlboeck, Helmholtz Zentrum München, Institut für Epidemiologie, Ingolstädter Landstr. 1, D-85764 Neuherberg, Germany.

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To date, there is conflicting evidence whether the association between asthma and depression depends on the atopic or non-atopic asthma phenotype. This study investigates associations between emotional symptoms and atopic and non-atopic asthma in school-aged children.


Cross-sectional data on asthma and allergic diseases at the 10-year follow-up of two birth cohorts were collected by parent-reported physician diagnoses. Specific IgE levels including most common inhalant allergens (SX1) and food allergens (FX5) were measured by RAST-CAP FEIA. Atopic asthma was defined as asthma ever and positive specific IgE test, non-atopic asthma as asthma ever and no IgE sensitization. Emotional symptoms were assessed by parent-reported strength and difficulty questionnaire. Logistic regression modeling were applied to determine likelihood of emotional symptoms in children with atopic and non-atopic asthma controlling for socio-demographic factors, body mass index, atopic eczema, allergic rhinitis, and pubertal development.


Non-atopic asthma was associated with about 3-fold higher likelihood of emotional symptoms compared to children with no asthma (ORadj = 2.90, CI95% = 1.46–5.73). Atopic asthma was not associated with emotional symptoms (ORadj = 1.35, CI95% = 0.81–2.26).


Atopic and non-atopic asthma in children might have different etiologies, whereas for non-atopic asthma, emotional symptoms are relevant, this is not the case in atopic asthma. The relationship between the non-atopic asthma phenotype and emotional symptoms might be dependent on gender.