The Effects of Caregiver Depression on Childhood Asthma: Pathways and Mechanisms

Publication date: Available online 4 July 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Beatrice L. Wood, E. Sherwood Brown, Heather K. Lehman, David A. Khan, Min Jung Lee, Bruce D Miller
ObjectiveThis paper reviews the literature regarding the effects of caregiver depression on childhood asthma, and integrates the findings into a multilevel model of pathways by which these effects occur. The purpose is to further the understanding of the complex biopsychosocial nature of childhood asthma, and the key role that is played by caregiver depression.Data SourcesPUBMED, (2007 to present for a 10 year search), and Google Scholar (2017-2018 for most recent publications).Study SelectionsStudies selected were recent, empirical or metaanalytic, conducted in humans, and had specific relevance to one or more of the identified pathways. Articles published before 2007 were included if deemed essential because they addressed key pathways, for which there were no more recent articles.ResultsReview of the literature substantiates that caregiver depression plays a key role in the socio-familial-psychological-biological cascade of effects on childhood asthma. Childhood asthma outcomes are affected indirectly by socio-economic status and family stress mediated by caregiver depression, which impacts disease management, and/or stress and depression in the child, which, in turn, affect asthma through alterations in immune modulation and autonomic regulation.ConclusionFindings indicate that future research should concentrate on mediators and moderators to further clarify the complex interplay of these factors affecting childhood asthma. The indings also have substantial translational implications. Given that child stress and depression contribute to asthma disease activity, and that treating caregiver depression improves child stress and depression, there is strong rationale for treating depressed caregivers of children with asthma as a component means of improving childhood asthma control.



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