PREVALENCE OF BEHAVIOR PROBLEMS IN US CHILDREN WITH ASTHMA

Objectives: To present national population-based estimates of the prev alence of parent-reported emotional and/or behavioral problems in chil dren with asthma and the relationship of medical comorbidity and asthm a severity with behavior problems. Design: Cross-sectional study of th e 1988 National Health Interview on Child Health. Main Outcome Measure s: Parent responses to a checklist of child health conditions were use d to assign school-age children (5 to 17 years old) into one of four g roups: children without reported chronic conditions; children with ast hma alone; children with asthma and additional reported chronic condit ions; and children with the same chronic conditions, but without asthm a. Parental responses to the Behavior Problem Index (BPI) were used fo r construction of an overall BPI score, as well as subscale scores. Cr oss-tabulation and linear and logistic regression were used to determi ne the relation of the different condition categories to emotional and /or behavioral problems expressed by relative values of the BPI. Resul ts: Children with asthma and comorbid conditions had a mean BPI score of 7.3, compared with 5.4 for children without chronic conditions, and all subscale scores, except those for antisocial conduct and immature behavior, were significantly elevated. Using logistic regression to c ontrol for confounding variables, children with severe asthma alone ha d nearly three times the odds (odds ratio, 2.96; 95% confidence interv al, 1.22 to 7.17) and children with asthma plus comorbid conditions ne arly twice the odds (odds ratio, 1.86; 95% confidence interval, 1.20 t o 2.90) of children without chronic conditions to have severe behavior problems. Conclusions: Severe asthma and asthma with medical comorbid ity represent significant risk factors for emotional and/or behavioral problems. Clinicians caring for children with asthma and their famili es should be aware of the relationship between asthma and emotional an d/or behavioral problems and anticipate that a substantial number of t heir patients may have mental health services needs.