Stress and Asthma in Children

Emotional distress can play a significant role in precipitating asthma attacks and increasing their severity as well as frequency. This is especially common in children and one study reported in Thorax found that asthmatic kids faced quadruple the risk of an attack after experiencing a stressful event that involved family relationships such as divorce, separation, deaths, births or having to move. Researchers studied 60 children between the ages of 6 and 13 who had suffered from asthma for at least three years and had them keep daily records of acute attacks noting their duration and severity. They also periodically interviewed them as well as their parents and family members to obtain information about stressful life events over the 18-month study period. An analysis of the data revealed that the participants were four times as likely to experience a sudden worsening of symptoms within two days of a stressful event and that they had double the risk of a recurrence of this about six weeks later. It was suggested that this could be due to a disturbed immune system function as well as neuroendocrine influences. In a more recent study, Canadian researchers followed 40 asthmatic children and healthy controls for six months and recorded the frequency and severity of stressful events. Blood levels of glucocorticoid and beta-2 adrenergic receptors were measured periodically. They reported that these two indicators of adrenal cortical function were diminished following stressful events in asthmatic children and the opposite trend was seen in healthy controls. The attenuated expression of both these receptors could lead to airway inflammation and constriction following exposure to allergic triggers and also reduce the effect of asthma medications that frequently include cortisone-like steroids.

References

Sandberg S, Järvenpää S et al. Asthma exacerbations in children immediately following stressful life events. Thorax, Dec 2004; 59: 1046 – 1051.

Gregory E. Miller GE, Chen E. Life stress and diminished expression of genes encoding glucocorticoid receptor and 2-adrenergic receptor in children with asthma. Proceedings of the National Academy of Sciences, April 2006; 103: 5496-5501.