Common behavioral problems among children with asthma: is there a role of asthma treatment?

Studies such as one in Taiwan have indicated that Tourette syndrome is linked to higher than expected rates of asthma and allergic illness. But does the asthma – or its treatment – contribute to some of the behavioral problems we see in youth with TS+? I came across a study conducted in Turkey that suggest that asthma treatments may correlate with behavioral problems. Here is the abstract:

BACKGROUND: An increased prevalence of behavioral problems has been described among children with asthma.

OBJECTIVE: To investigate those associations between common behavioral problems and asthma, with an emphasis on the roles of medications used for asthma.

METHOD: We studied 409 children who had been followed-up in pediatric allergy clinics and 157 age-matched healthy controls. A diagnostic and statistical manual disorder-referenced symptom inventory was used to assess “attention deficit-hyperactivity disorder” (ADHD), “attention deficit” (AD), “hyperactivity and impulsivity” (HI), and “oppositional defiant disorder” (ODD) behavioral problems.

RESULTS: The study group consisted of 409 patients (male: 251, female: 158), with a mean age of 9.0 ± 2.67 years, and the control group consisted of 157 children (male: 75, female: 82), with a mean age of 9.0 ± 2.86 years. Prevalences of AD, hyperactivity, ADHD, and ODD were not significantly different between the study and control groups. Among those patients receiving leukotriene antagonist (LA) drugs adjunctive to inhaled corticosteroids (ICS), duration of treatment was correlated with total scores calculated for hyperactivity (P = .035, r = 0.432), AD (P = .044, r = 0.414), ADHD (P = .042, r = 0.418), and ODD (P = .032, r = 0.439). Among patients with asthma, children with ODD had a significantly longer duration of LA+ICS use (P = .024) compared with those with no ODD. Patients with hyperactivity had a longer duration of ICS+LA use compared with those with no hyperactivity (P = .009). Patients with asthma receiving LA+ICS treatment had a higher risk for oppositional behavior (4.282 times compared with the control group [P = .042, confidence interval (CI): 1.542-15.949]) and 8.3 times compared with patients with asthma not using any drug (P = .021, CI: 1.419-48.543).

CONCLUSION: Rather than asthma itself, adjunctive use of ICS+LA therapy appears to be related with symptoms of common behavioral problems, including hyperactivity, AD, ADHD, and ODD and to increase the risk of ODD.

Reference:

Ann Allergy Asthma Immunol. 2011 Mar;106(3):200-4. Epub 2011 Jan 6.
Saricoban HE, Ozen A, Harmanci K, Razi C, Zahmacioglu O, Cengizlier MR.
Common behavioral problems among children with asthma: is there a role of asthma treatment?