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Published ahead of print on March 11, 2005, doi:10.1164/rccm.200412-1669OC
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American Journal of Respiratory and Critical Care Medicine Vol 171. pp. 1224-1230, (2005)
© 2005 American Thoracic Society
doi: 10.1164/rccm.200412-1669OC

Original Article

Asthma and Panic in Young Adults

A 20-Year Prospective Community Study

Gregor Hasler, Peter J. Gergen, David G. Kleinbaum, Vladeta Ajdacic, Alex Gamma, Dominique Eich, Wulf Rössler and Jules Angst

Mood and Anxiety Disorders Program, Intramural Research Program, National Institute of Mental Health, and Asthma, Allergy, Inflammation Branch, Division of Allergy, Immunology, Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland; Psychiatric University Hospital, Zurich, Switzerland; and Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia

Correspondence and requests for reprints should be addressed to Gregor Hasler, M.D., National Institutes of Health, National Institute of Mental Health, Mood and Anxiety Disorders Program, 15K North Drive, Room 200, MSC 2670, Bethesda, MD 20892-2670. E-mail: g.hasler{at}bluewin.ch

Rationale: Psychologic factors are increasingly recognized to influence the onset and course of asthma. Previous cross-sectional community-based studies have provided evidence for a relatively specific association between asthma and panic. Objectives: To examine concurrent and longitudinal associations between asthma and panic in young adults. Measurements and Main Results: Prospective community-based cohort study of young adults (n = 591) followed between ages 19 and 40. Information was derived from six subsequent semistructured diagnostic interviews conducted by professionals. Cross-sectionally (over the whole study period), asthma was more strongly associated with panic disorder (odds ratio [OR] = 4.0; 95% confidence interval [CI], 1.7, 9.3) than with any panic, which included panic disorder and panic attacks (OR = 2.1; 95% CI, 1.1, 4.5). Longitudinally, after adjusting for potentially confounding variables, active asthma predicted subsequent panic disorder (OR = 4.5; 95% CI, 1.1, 20.1), and the presence of panic disorder predicted subsequent asthma activity (OR = 6.3; 95% CI, 2.8, 14.0). Asthma predicted any panic (OR = 2.7; 95% CI, 1.1, 7.1), whereas any panic did not predict subsequent asthma activity. Associations were stronger in smokers than in nonsmokers, and stronger in women than in men. Smoking, early-childhood anxiety, and a family history of allergy were important confounders of the asthma–panic association. Conclusions: This is the first long-term follow-up study on asthma and panic. It showed dose–response-type relationships between panic and asthma, and bidirectional longitudinal associations between the two conditions. It provided evidence for familial factors and smoking as possible shared etiologic explanations.

Key Words: anxiety • child development • respiratory tract disease • sex • smoking




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