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The effects of caregiver depression on childhood asthma: Pathways and mechanisms
Beatrice L Wood1, E Sherwood Brown2, Heather K Lehman3
1Department of Psychiatry, Jacobs School of Medicine, University at Buffalo, Buffalo, New York; Department of Pediatrics, Jacobs School of Medicine, University at Buffalo, Buffalo, New York.
Insights
Caregiver depression significantly impacts childhood asthma through socioeconomic, familial, and biological pathways. Treating parental depression may improve child asthma control by reducing stress and depression in the child.
Area of Science:
- Pediatric pulmonology
- Psychoneuroimmunology
- Family medicine
Background:
- Childhood asthma is a complex condition influenced by biopsychosocial factors.
- Caregiver depression is increasingly recognized as a significant environmental influence on pediatric health outcomes.
- Understanding the pathways linking caregiver depression to childhood asthma is crucial for effective management.
Purpose of the Study:
- To review existing literature on the effects of caregiver depression on childhood asthma.
- To integrate findings into a multilevel model illustrating these effects.
- To enhance understanding of the complex interplay between caregiver mental health and childhood asthma.
Main Methods:
- Systematic literature review of PubMed and Google Scholar (2007-2018).
- Inclusion of recent empirical and meta-analytic studies, with essential older articles.
- Focus on studies relevant to identified socioeconomic, familial, psychological, and biological pathways.
Main Results:
- Caregiver depression influences childhood asthma via socioeconomic, familial, psychological, and biological pathways.
- Effects are mediated by socioeconomic status, family stress, disease management, and child's stress/depression.
- Child stress and depression impact asthma through immune and autonomic regulation.
Conclusions:
- Caregiver depression is a key factor in the cascade affecting childhood asthma.
- Future research should focus on mediators and moderators in this complex relationship.
- Treating caregiver depression offers a viable strategy to improve childhood asthma control by alleviating child stress and depression.
Objective:
To review the literature regarding the effects of caregiver depression on childhood asthma and integrate the findings into a multilevel model of pathways by which these effects occur to further the understanding of the complex biopsychosocial nature of childhood asthma and the key role that is played by caregiver depression.
Data Sources:
PubMed was searched for articles published from 2007 to the present (10-year search), and Google Scholar was searched for articles published in 2017 and 2018 to identify the most recent publications.
Study Selections:
Studies selected were recent, empirical, or meta-analytic, conducted in humans, and had specific relevance to one or more of the identified pathways. Articles published before 2007 were included if deemed essential because they addressed key pathways, for which there were no more recent articles.
Results:
Review of the literature substantiates that caregiver depression plays a key role in the socioeconomic, familial, psychological, and biological cascade of effects on childhood asthma. Childhood asthma outcomes are affected indirectly by socioeconomic status and family stress mediated by caregiver depression, which affects disease management, and/or stress and depression in the child, which, in turn, affect asthma through alterations in immune modulation and autonomic regulation.
Conclusion:
Findings indicate that future research should concentrate on mediators and moderators to further clarify the complex interplay of these factors that affect childhood asthma. The findings also have substantial translational implications. Given that child stress and depression contribute to asthma disease activity and that treating caregiver depression improves child stress and depression, there is strong rationale for treating depressed caregivers of children with asthma as a component means of improving childhood asthma control.
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