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Published ahead of print on January 19, 2006, doi:10.1164/rccm.200511-1706PP

Am. J. Respir. Crit. Care Med., Volume 173, Number 9, May 2006, 953-957

A more recent version of this article appeared on May 1, 2006
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Submitted on November 3, 2005
Accepted on January 17, 2006

Risk-taking, Depression, Adherence, and Symptom Control in Adolescents and Young Adults with Asthma

Bruce G Bender1*

1 Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO, USA; Department of Psychiatry, University of Colorado Health Sciences Center, Denver, CO, USA

* To whom correspondence should be addressed. E-mail: benderb{at}njc.org.

Abstract. Risk behaviors, including tobacco, alcohol, and drug use, are common in adolescents and young adults. Those who engage in one risk behavior are likely to engage in additional health risk behaviors, and as the number of risk behaviors increase, depression co-morbidity emerges. For young people with chronic illness, risk behavior and depression are also common. There is some evidence that both depression and risk behavior are associated with nonadherence to medications, poor treatment outcomes, and death. The relationship between depression and asthma may involve more than one causal pathway and includes the possibility that depression can lead to a sense of hopelessness that erodes adherence and other health-promoting behavior, or that depression impacts asthma directly by altering the immune system. An assessment of the interplay between risk behavior, depression, adherence, and asthma can add important new information to our understanding about how to identify and treat those at greatest risk for poorly controlled disease and asthma-related death. New behavioral studies must overcome the shortcomings frequently seen in previous research and include well-designed and controlled investigations utilizing valid behavioral measures of risk behavior, mood disorder, and adherence; recruitment that includes sufficient numbers of subjects and gives careful consideration of selection bias; and employment of multivariate data modeling to allow for simultaneous statistical examination of multiple relationships.


Key words: Patient non-adherence, risk behavior, depression, adolescent




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