Anxiety is associated with asthma severity in adolescents: a school-based epidemiological study

Asthma is one of the most prevalent noncommunicable chronic diseases worldwide. Adolescents' emotional state has been associated with asthma symptoms and disease severity. Given the epidemiological relevance of anxiety and asthma during adolescence, it is important to investigate the association between these conditions. The objective of this study is to analyze the association between social anxiety and asthma in adolescents.

This was a cross-sectional school-based study conducted among adolescents aged 14 to 19 years. Data were collected using the adapted Global School-based Student Health Survey (GSHS), the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, and the Social Anxiety Scale for Adolescents (SAS-A). Logistic regression analysis was performed to assess the association between asthma and the following variables: social anxiety, age, sex, physical activity level, maternal education, parental asthma, parental smoking, and municipality.

A total of 4514 adolescents were assessed, 54.6% of whom were female. Active asthma was present in 26.5% of participants, while severe asthma was reported by 10%. Mild anxiety affected 46.7%, and moderate to intense anxiety was reported by 27.2% of participants. Adolescents with moderate to intense anxiety had a higher likelihood of active asthma (OR = 1.6; 95%CI: 1.3-2.0) and more than twice the risk of severe asthma (OR = 2.1; 95%CI: 1.5-3.0).

An association was found between asthma and social anxiety symptoms, with increased anxiety levels correlating with greater asthma severity. These findings highlight the potential relevance of considering mental health in asthma management strategies.