Patterns of family interaction were compared in the families of 22 children with chronic asthma, 30 children with diabetes mellitus, and six healthy children. The groups were similar in terms of age (range 4-14 years and mean 10.2 years). Peak expiratory flow and signs of allergy were correlated with family interaction in the subjects with asthma. The following significant findings were made. Family interaction was more disturbed in asthma compared with both the diabetic and the healthy groups. In most of the disturbed families interaction patterns were rigid and enmeshed, but a few showed chaotic and disengaged patterns. There was a negative correlation between peak expiratory flow and disturbed cohesion in non-steroid dependent cases. The severely ill children with asthma living in families with a normal cohesion score had higher IgE concentrations than children living in disturbed families. It is concluded that family interaction should be considered to be an important dimension in the investigation of severe childhood asthma.
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