Asthma Control Worse for Youth in More Chaotic Families

By Anne Harding

July 12, 2019

NEW YORK (Reuters Health) - Family chaos is a key pathway in the relationship between parent depression and child asthma control, according to new findings.

"The clinical implications of this study are important and not something that has really been studied before," Dr. Sally M. Weinstein of the University of Illinois at Chicago, the study’s first author, told Reuters Health by phone. "Improving the level of organization and routine in the family can really improve asthma care and maybe mitigate the risky effect of psychosocial factors like adult depression and child depression."

Dr. Weinstein and her colleagues looked at baseline data from the Asthma Action at Erie Trial, which is testing community-based asthma interventions in partnership with Erie Family Health Centers.

Dr. Weinstein and her colleagues looked at 223 trial participants 5 to 16 years old with uncontrolled asthma. Among parents, 14.8% had moderate to severe depressive symptoms, 19.3% met criteria for post-traumatic stress disorder (PTSD) and 46.6% had experienced a traumatic event.

Among children, 18% had elevated or very elevated levels of depression and 51.3% had clinically significant PTSD symptoms, the researchers report in Pediatrics, online July 9.

Family chaos, based on the 15-item Confusion, Hubbub, and Order Scale (CHAOS), ranged from 0 to 13, with a mean of 3.2.

Parent levels of depressive symptoms and emotional support, but not PTSD, were associated with Asthma Control Test (ACT) scores. Multivariate analysis found family chaos was the only factor independently related to ACT.

Children in the top quartile for family chaos had an average ACT of 15.58, versus 18.94 for those in the least chaotic families, a "clinically meaningful difference," the researchers write.

"Integrated behavioral interventions that target a reduction in family chaos via development of family routines, structure, and predictability, particularly around medication, can help to optimize asthma care," they conclude.

The study was funded by the National Heart, Lung, and Blood Institute.


Pediatrics 2019.