Quality of Mental Health Care for Youth With Asthma and Comorbid Anxiety and Depression

Bibliographic Data

ID9101284
AuthorsWayne J Katon, Wayne Katon (Group Health Cooperative, corresponding author), Laura Richardson (0000-0003-3634-4641, Group Health Cooperative), Joan Russo (0000-0002-2175-9441, University of Washington, corresponding author), Paula Lozano (0000-0002-3378-5532, University of Washington), Elizabeth Mccauley (0000-0001-9763-9262, University of Washington, corresponding author)
Year2006
Volume44
Issue12
Pages1064-1072
Publication date2006-12-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/01.mlr.0000237421.17555.8f
PMID17122709
OpenAlexW2094458233
LanguageEN
Citations received5
References cited41

OBJECTIVES: Youth with asthma have a high rate of anxiety and depressive disorders, and these comorbid disorders are associated with increased asthma symptom burden and functional impairment. This study examined the rates and predictors of recognition of anxiety and depressive disorders among youth (ages 11 to 17) with asthma who are seen in primary care settings as well as the quality of mental health care provided to those with comorbid anxiety and depression over a 12-month period. METHODS: This study used automated utilization and pharmacy data from a health maintenance organization to describe the rate of recognition of Diagnostic and Statistical Manual of Mental Disorders, edition IV, anxiety and depressive disorders and the quality of mental health care provided for the 17% of youth with asthma and comorbid anxiety and/or depression during the 12-month period prior to diagnosis. Psychiatric diagnoses were based on a telephone version of the Computerized Diagnostic Interview Schedule for Children (Version 4.0). RESULTS: Approximately 35% of youth with 1 or more anxiety and depressive disorders and 43% of those with major depression were recognized by the medical system during a 12-month period. Greater functional impairment (odds ratio [OR] 3.32, 95% confidence interval [CI] 1.25-8.79), higher severity on parent-rated anxiety and depressive symptoms (OR 2.49, 95% CI 1.04-6.00), and a greater number of primary care visits (OR 1.26, 95% CI 1.10-1.44) were associated with significantly higher recognition rates while having Medicaid or Washington state medical insurance was associated with lower rates of recognition (OR 0.27, 95% CI 0.08-0.92). Only approximately 1 in 5 youths with comorbid major depression received an adequate dosage and duration of antidepressant medication, and only 1 in 6 received a minimally adequate number of psychotherapy sessions (> or =4 visits). CONCLUSION: Rates of recognition of comorbid anxiety and depressive disorders are low in youth with asthma and few youth with asthma and comorbid anxiety and depression receive guideline-level mental health treatment

Anxiety · Anxiety disorder · Asthma · Comorbidity · Depression (economics) · Health care · Medicaid · Mental health · Odds ratio · Psychiatry · Asthma and respiratory diseases · Child and Adolescent Psychosocial and Emotional Development · Internal Medicine · Medicine · Mental Health Treatment and Access

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