Depression or anxiety in adult twins is associated with asthma diagnosis but not with offspring asthma
Abstract
BACKGROUND: Asthma is common in both children and adults in the Western world, just like anxiety and depression. While some research has revealed that these diseases might share important environmental and pathophysiological aspects, the exact mechanisms still remain unclear. OBJECTIVE: To study the correlation firstly between depression or anxiety and asthma diagnosis in adult twins and secondly the association between parental depression or anxiety and offspring asthma in children of twins. METHODS: In total, 24 685 adult twins aged 20-47 years were interviewed or completed a Web-based questionnaire and their children were identified through the Multi-Generation Register. Asthma diagnosis was obtained from the Patient Register and the Prescribed Drug Register. Assessment of depression and anxiety was obtained from questionnaires using Center for Epidemiologic Studies Depression Scale (CES-D), major depression and generalized anxiety disorder (GAD) from DSM-IV. The association between depression or anxiety and asthma was analyzed with logistic regression adjusting for confounders in twins and offspring. To address genetic and familial environmental confounding, we performed a cotwin analysis using disease-discordant twin pairs. RESULTS: We found an association between asthma and CES-D, major depression and GAD, for example adjusted OR for major depression and register-based asthma 1.56 (1.36-1.79). Most of the point estimates remained in the co-twin control analysis, indicating that the association was likely not due to genetic or familial environmental factors. There was no association between parental depression and/or anxiety and asthma diagnosis in the offspring which implies lack of genetic confounding. CONCLUSIONS: We found an association between own asthma diagnosis and anxiety or depression, but not with offspring asthma. Our results indicate that the associations were not due to confounding from genes or environment shared by the twins.
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There is an established association between asthma and anxiety, and this association is linked to poor health outcomes.
“There is an established relationship between anxiety and asthma, which is associated with poor health outcomes.”
From Targeting excessive avoidance behavior to reduce anxiety related to asthma: A feasibility study of an exposure-based treatment delivered online (2021) · cites this paper as Tedner et al., 2016
Cites
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)
American Psychiatric Association (2000) · doi:10.1176/appi.books.9780890423349 · Cited by 11,069 · see citing works
Asher, M. I., Montefort, S., Björkstén, B., Lai, C. K., Strachan, D. P., Weiland, S. K., & Williams, H. (2006) · The Lancet · doi:10.1016/s0140-6736(06)69283-0 · Cited by 4,223 · see citing works
The global burden of asthma: executive summary of the GINA Dissemination Committee Report
Masoli, M., Fabian, D., Holt, S., Beasley, R. W., & Program, G. I. F. A. (. (2004) · Allergy · doi:10.1111/j.1398-9995.2004.00526.x · Cited by 3,521 · see citing works
McLean, C. P., Asnaani, A., Litz, B. T., & Hofmann, S. G. (2011) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2011.03.006 · Cited by 2,519 · see citing works
Two Shorter Forms of the CES-D Depression Symptoms Index
Kohout, F. J., Berkman, L. F., Evans, D. A., & Cornoni‐Huntley, J. C. (1993) · Journal of Aging and Health · doi:10.1177/089826439300500202 · Cited by 2,292 · see citing works
Cross-national epidemiology of DSM-IV major depressive episode
Bromet, E., Andrade, L. H., Hwang, I., Sampson, N. A., Alonso, J., de Girolamo, G., de Graaf, R., Demyttenaere, K., Hu, C., Iwata, N., et al. (2011) · BMC Medicine · doi:10.1186/1741-7015-9-90 · Cited by 2,221 · see citing works
The Swedish Twin Registry in the Third Millennium: An Update
Lichtenstein, P., Sullivan, P. F., Cnattingius, S., Gatz, M., Johansson, S., Carlström, E. L., Björk, C., Svartengren, M., Wolk, A., Klareskog, L., et al. (2006) · Twin Research and Human Genetics · doi:10.1375/183242706779462444 · Cited by 399 · see citing works
Mental Disorders and Asthma in the Community
Goodwin, R. D., Jacobi, F., & Thefeld, W. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.11.1125 · Cited by 347 · see citing works
The Swedish Twin Registry in the Third Millennium: An Update
Lichtenstein, P., Sullivan, P. F., Cnattingius, S., Gatz, M., Johansson, S., Carlström, E. L., Björk, C., Svartengren, M., Wolk, A., Klareskog, L., et al. (2006) · Twin Research and Human Genetics · doi:10.1375/twin.9.6.875 · Cited by 327 · see citing works
Mental disorders among adults with asthma: results from the World Mental Health Survey
Scott, K. M., Korff, M. V., Ormel, J., Zhang, M.-Y., Bruffaerts, R., Alonso, J., Kessler, R. C., Tachimori, H., Karam, E. G., Levinson, D., et al. (2007) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2006.12.006 · Cited by 302 · see citing works
Parental Stress as a Predictor of Wheezing in Infancy: A Prospective Birth-Cohort Study
Wright, R. J., Cohen, S., CAREY, V. J., Weiss, S. T., & Gold, D. R. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.165.3.2102016 · Cited by 272 · see citing works
Mothers' anxiety during pregnancy is associated with asthma in their children
Cookson, H., Granell, R., Joinson, C. J., Ben‐Shlomo, Y., & Henderson, A. J. (2009) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2009.01.042 · Cited by 259 · see citing works
Asthma and depressive and anxiety disorders among young persons in the community
GOODWIN, R. D., FERGUSSON, D. M., & HORWOOD, L. J. (2004) · Psychological Medicine · doi:10.1017/s0033291704002739 · Cited by 229 · see citing works
Deconstructing major depression: a validation study of the DSM-IV symptomatic criteria
Lux, V., & Kendler, K. S. (2010) · Psychological Medicine · doi:10.1017/s0033291709992157 · Cited by 204 · see citing works
Maternal Prenatal Anxiety and Stress Predict Infant Illnesses and Health Complaints
Beijers, R., Jansen, J., Riksen-Walraven, M., & de Weerth, C. (2010) · PEDIATRICS · doi:10.1542/peds.2009-3226 · Cited by 203 · see citing works
Kozyrskyj, A. L., Mai, X., McGrath, P. J., HayGlass, K. T., Becker, A. B., & Macneil, B. J. (2007) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200703-381oc · Cited by 181 · see citing works
Sex Differences in Adolescent Depression: Do Sex Hormones Determine Vulnerability?
Naninck, E. F. G., Lucassen, P. J., & Bakker, J. (2011) · Journal of Neuroendocrinology · doi:10.1111/j.1365-2826.2011.02125.x · Cited by 160 · see citing works
Validation of asthma and eczema in population‐based Swedish drug and patient registers
Örtqvist, A. K., Lundholm, C., Wettermark, B., Ludvigsson, J. F., Ye, W., & Almqvist, C. (2013) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.3465 · Cited by 137 · see citing works
Self-citationten Thoren, C., & Petermann-Rocha, F. E. (2000) · Respiratory Medicine · doi:10.1053/rmed.1999.0757 · Cited by 128 · see citing works
Anxiety and depression in asthma
Di Marco, F., Santus, P., & Centanni, S. (2011) · Current Opinion in Pulmonary Medicine · doi:10.1097/mcp.0b013e328341005f · Cited by 119 · see citing works
de Marco, R., Pesce, G., Girardi, P., Marchetti, P., Rava, M., Ricci, P., & Marcon, A. (2012) · Pediatric Allergy and Immunology · doi:10.1111/j.1399-3038.2012.01346.x · Cited by 106 · see citing works
Chiu, Y.-H. M., Coull, B. A., Cohen, S., Wooley, A., & Wright, R. J. (2012) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201201-0162oc · Cited by 105 · see citing works
Schizophrenia and smoking: Evidence for a common neurobiological basis?
Stassen, H. H., Bridler, R., H�gele, S., Hergersberg, M., Mehmann, B., Schinzel, A., Weisbrod, M., & Scharfetter, C. (2000) · American Journal of Medical Genetics · doi:10.1002/(sici)1096-8628(20000403)96:2 · Cited by 89 · see citing works
Psychiatric Symptomatology and Disorders in Caregivers of Children With Asthma
Brown, E. S., GAN, V. N., Jeffress, J., Mullen-Gingrich, K., Khan, D. A., Wood, B. L., Miller, B. D., Gruchalla, R. S., & Rush, A. J. (2006) · PEDIATRICS · doi:10.1542/peds.2006-1119 · Cited by 76 · see citing works
Parental psychosocial stress and asthma morbidity in Puerto Rican twins
Lange, N. E., Bunyavanich, S., Silberg, J. L., CANINO, G. J., ROSNER, B. A., & Celedon, J. C. (2010) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2010.11.010 · Cited by 75 · see citing works
Walters, P., Schofield, P., Howard, L. M., Ashworth, M. J., & Tylee, A. T. (2011) · PLoS ONE · doi:10.1371/journal.pone.0020750 · Cited by 72 · see citing works
Anxiety and panic fear in adults with asthma: prevalence in primary care
Cooper, C. L., Parry, G. D., Saul, C., Morice, A. H., Hutchcroft, B. J., Moore, J., & Esmonde, L. (2007) · BMC Family Practice · doi:10.1186/1471-2296-8-62 · Cited by 59 · see citing works
The STAGE cohort: A prospective study of tobacco use among Swedish twins
Furberg, H. F., Lichtenstein, P., Pedersen, N., Thornton, L. M., Bulik, C. M., Lerman, C., & Sullivan, P. F. (2008) · Nicotine & Tobacco Research · doi:10.1080/14622200802443551 · Cited by 52 · see citing works
Maternal Bereavement and Childhood Asthma—Analyses in Two Large Samples of Swedish Children
Fang, F., Höglund, C. O., Arck, P., Lundholm, C., Långström, N., Lichtenstein, P., Lekander, M., & Almqvist, C. (2011) · PLoS ONE · doi:10.1371/journal.pone.0027202 · Cited by 52 · see citing works
Self-citationFamilial risks for asthma among twins and other siblings based on hospitalizations in Sweden
Hemminki, K., Li, X., Sundquist, K., & Sundquist, J. (2007) · Clinical & Experimental Allergy · doi:10.1111/j.1365-2222.2007.02737.x · Cited by 44 · see citing works
Gender differences in depression: a study of older unlike-sex twins
Takkinen, S., Gold, C., Pedersen, N. L., Malmberg, B., Nilsson, S., & Rovine, M. J. (2004) · Aging & Mental Health · doi:10.1080/13607860410001669714 · Cited by 39 · see citing works
Asthma and Major Depressive Episode in Adolescents in France
Delmas, M.-C., Guignon, N., Chee, C. C., Fuhrman, C., Herbet, J.-B., & Gonzalez, L. (2011) · Journal of Asthma · doi:10.3109/02770903.2011.585410 · Cited by 29 · see citing works
Twins' risk of childhood asthma mediated by gestational age and birthweight
Ullemar, V., Lundholm, C., & Almqvist, C. (2015) · Clinical & Experimental Allergy · doi:10.1111/cea.12547 · Cited by 27 · see citing works
Self-citationA Note on Twin–Singleton Differences in Asthma
Thomsen, S. F., Kyvik, K. O., & Backer, V. (2008) · Twin Research and Human Genetics · doi:10.1375/twin.11.2.161 · Cited by 17 · see citing works
Havland, I., Lundholm, C., Lichtenstein, P., Neiderhiser, J. M., Ganiban, J. M., Spotts, E. L., Walum, H., Reiss, D., & Almqvist, C. (2013) · PLoS ONE · doi:10.1371/journal.pone.0066040 · Cited by 13 · see citing works
Self-citationMaternal Mental Health and Childhood Asthma among Puerto Rican Youth: The Role of Prenatal Smoking
Goodwin, R. D., CANINO, G. J., Ortega, A. N., & Bird, H. (2009) · Journal of Asthma · doi:10.1080/02770900903072051 · Cited by 9 · see citing works
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Self-citationBrown, E. S., Sayed, N., Enkevort, E. A. V., Kulikova, A., Nakamura, A., Khan, D. A., Ivleva, E. I., Sunderajan, P., Bender, B. G., & Holmes, T. (2018) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2018.01.010 · Cited by 56 · see citing works
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- Authors
- Tedner, S. G., Lundholm, C., Olsson, H., & Almqvist, C.
- Affiliations
- Karolinska Institutet (SE)
- Karolinska University Hospital (SE)
- Corresponding author
- Tedner, S. G.
- Venue
- Clinical & Experimental Allergy
- Publisher
- Wiley
- Published
- 2016-05-26
- Volume
- 46
- Issue
- 6
- Pages
- 803-812
- ISSN
- 0954-7894 (ISSN-L)
- 1365-2222
- OpenAlex
- W2299155972
- Cited by
- 23
- References
- 36
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 1 · 2019: 4 · 2018: 3 · 2017: 2 · 2016: 3
- FWCI
- 3.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical & Experimental Allergy (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion)
- Open Archive (Karolinska Institutet) (submittedVersion)
- Funders
- Stockholms Läns Landsting
- Vetenskapsrådet (2011‐3060)
- Forskningsrådet om Hälsa, Arbetsliv och Välfärd
- Hjärt-Lungfonden
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- asthma, depression, anxiety, generalized anxiety disorder, major depressive disorder, parental depression, twins, genetic confounding, childhood asthma
- MeSH terms
- Adult, Anxiety, Asthma, Depression, Female, Humans, Male, Middle Aged, Population Surveillance, Surveys and Questionnaires, Risk Factors, Sweden, Twins, Prevalence, Odds Ratio, Young Adult
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