THE YENTL SYNDROME IN CHILDHOOD ASTHMA - RISK-FACTORS FOR UNDERTREATMENT IN SWISS CHILDREN

Recent prevalence data for childhood asthma in Switzerland suggest a s ubstantial underdiagnosis which seems to be more pronounced in girls. We further analysed our data trying to specify risk factors for underd iagnosis and undertreatment. Our special interest was focused on femal e sex as there is evidence for a sex-dependent diagnosis and treatment of chronic disease in adults, called the Yentl syndrome. The data are derived from a parent completed questionnaire survey of a stratified cluster sample of schoolchildren aged 7, 12, and 15 years. Besides the 12 months prevalence of asthma symptoms and bronchodilator treatment, the lifetime prevalence of an asthma diagnosis was noted. With a resp onse rate of 97%, a total of 4353 completed questionnaires were analys ed. While age was not associated with undertreatment (except for exerc ise-induced symptoms in adolescents), the lack of a formal diagnosis o f asthma and atypical asthma symptoms other than wheeze such as chroni c night cough were confirmed as significant risk factors for undertrea tment. Of all boys reporting asthma symptoms 31% received bronchodilat or treatment compared with only 15% of the symptom-reporting girls (P < 0.001). For all particular asthma-related symptoms (except wheeze), significantly more boys than girls (approximately double) received tre atment. The physiological and psychological bases for these findings a re discussed and suggest that gender is an important risk factor for u nderdiagnosis and undertreatment of asthma. Our research indicates tha t the Yentl syndrome may exist for childhood asthma. (C) 1995 Wiley-Li ss, Inc.