For Kids With Asthma, Depression Makes ER Visit More Likely

New research suggests that anxiety and depression can make it hard for some kids to manage their asthma.

Young patients with all three conditions ended up in the emergency room nearly twice as often as kids who only struggle with asthma, the study found.

“Asthma self-management is complex, requiring recognition of symptoms, adherence to medication and avoidance of triggers,” explained study first author Dr. Naomi Bardach. She is from the University of California, San Francisco’s department of pediatrics and Institute for Health Policy Studies.

“The symptoms of anxiety and depression can make it more challenging to follow treatment, leading to more ER visits,” she added in a university news release. “There also may be a greater tendency to use the ER for supportive services, even in the absence of a serious asthma attack.”

Though many of these emergency department visits are not necessary, they account for 62% of asthma-related costs, the investigators found.

Anxiety and depression are more common in children with asthma than in those without the lung disease, the researchers noted. Among the asthma patients in the study, just over 11% had anxiety and nearly 6% had depression. This compared with about 7% and 3%, respectively, for children aged 3 to 17 in the general population, based on data from the U.S. Centers for Disease Control and Prevention.

For the study, the researchers collected data on more than 65,000 patients with asthma, aged 6 to 21. The findings showed that nearly 8% also had both depression and anxiety. These patients had almost twice the rate of emergency department visits as those without depression and anxiety.

Children with all three disorders may need more intensive care to help them stick with their medication and mental health care for their anxiety and depression, Bardach suggested.

“The study highlights a population of children and youth who may benefit from more intensive care coordination,” she said. “This may mean more careful counseling to improve medication compliance and symptom recognition. It may also mean improved mental health care for children in whom untreated depression or anxiety may hinder asthma self-management.”

The report was published online Sept. 25 in the journal Pediatrics.

More information

For more on asthma, head to the U.S. National Heart, Lung, and Blood Institute.