子どもの喘息発作における急性および慢性ストレスの役割

S Sandberg¹, J Y Paton, S Ahola

¹Hospital for Children and Adolescents, University of Helsinki, Finland.

Lancet (London, England)

|October 21, 2000

まとめ

重篤な人生の出来事は,子供の喘息発作を誘発する可能性があります. このリスクは,子供が継続的な慢性的なストレスを経験している場合,より高く,より早く発生します.

科学分野:

小児肺病学について
精神病体医学は精神病体医学である.
児童心理学児童心理学について

背景:

高いストレスレベルは,遺伝的傾向のある子供の喘息発症と罹病率の増加と関連しています.
既存の研究は,ストレスと喘息の重症度との相関関係を示唆しています.

研究の目的:

ストレスの多い経験が,既発性喘息の子どもにおいて,新たな喘息の悪化を早めるかどうかを調査する.
喘息発作に対する重度のライフイベントや慢性ストレス要因の影響を定量化するために.

主な方法:

子どもの喘息患者の18ヶ月のフォローアップ.
日記とピークフロー測定による継続的な喘息モニタリング.
重複したインタビューで,人生の出来事や心理的社会的な経験を評価し,重度のネガティブな人生の出来事や慢性的なストレス要因を含む.

主要な成果:

重度のライフイベントは,特にイベント後の2-6週間 (OR 1.71-2.17) で,喘息発作のリスクを大幅に増加させた.
リスクは,重度のイベントが高い慢性ストレスと一致したときに増幅され,加速された (2週間以内に) (OR 2.98).
女性の性別,ベースラインの重症度,頻度の高い発作,季節,親の喫煙などの要因は,発症リスクを高め,社会的階級や慢性的なストレスは,全体的な発症頻度と直接相関していない.

結論:

重度のネガティブな人生の出来事は,数週間以内に,子供における喘息発作のリスクを高めます.
複数の慢性ストレス要因の存在は,このリスクを拡大し,喘息の悪化の潜伏期間を短縮します.

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