Article Text

Download PDFPDF
Anxiety, depression and self-esteem in children with well-controlled asthma: case–control study
  1. Sarah L Letitre1,
  2. Eric P de Groot1,
  3. Eelco Draaisma,
  4. Paul L P Brand1,2
  1. 1Princess Amalia children's centre, Isala Hospital, Zwolle, The Netherlands
  2. 2UMCG Postgraduate School of Medicine, University Medical Centre and University of Groningen, Groningen, The Netherlands
  1. Correspondence to Professor Paul L P Brand, Princess Amalia Childrens Centre, Isala Hospital, PO Box 10400, 8000 GK Zwolle, The Netherlands; p.l.p.brand{at}


Objective Although asthma has been linked to psychological morbidity, this relationship may be confounded by poor asthma control. We aimed to compare the prevalence of anxiety, depression and low level of self-esteem in children with well-controlled asthma with that of healthy peers.

Setting Dedicated asthma clinic in a general hospital.

Patients 70 patients with mostly well-controlled asthma and 70 matched healthy controls.

Interventions Comprehensive asthma education, management and follow-up for asthma patients.

Main outcome measures Validated Dutch versions of the Childhood Depression inventory (CDI), Revised Fear Survey for Children (RFSC), Self Perception Profile for Children (SPC-C) and Adolescents (SPC-A) and State-Trait Anxiety Inventory for Children (STAIC). Asthma control assessed by asthma control questionnaire.

Results No significant differences were found in total scores between asthmatics and controls (95% CI for difference −0.2 to 2.9 for CDI, −5.9 to 11.2 for RFSC, −19.9 to 6.3 for SPC-C, −24.1 to 5.0 for SPC-A and −2.7 to 0.01 for STAIC). There were also no significant differences between asthmatics and controls in the prevalence of scores exceeding cut-off levels for clinically relevant anxiety (13.3 vs 13.0%, p=0.605), depression (12.9 vs 5.7%, p=0.243) or low self-esteem (21.4 vs 12.9%, p=0.175). A significant correlation was found between poorer asthma control and CDI (p=0.012) and anxiety trait symptoms (p<0.001).

Conclusions Children with well-controlled asthma enrolled in a comprehensive asthma management programme do not have an increased risk of anxiety, depression and poor self-esteem. Earlier reports of psychological comorbidity in asthma may have been related to inadequately controlled asthma.

  • Respiratory
  • Psychology

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.