Kindergarten-aged children who have Asthma may be at increased risk of becoming withdrawn, anxious or depressed as teenagers, according to new research.

If future research confirms the findings, it may be a good idea for doctors to pay close attention to early signs of behavior problems in children with Asthma, researchers advise in the May/June issue of the journal Psychosomatic Medicine.

“Asthma in childhood may cause development of internalizing symptoms in adolescence,” study author Dr. Rosa Alati said. Examples of internalizing behavior include excessive crying, feelings of worthlessness, sulking, anxiousness, lack of involvement with others, and feelings of guilt.

“Challenges for research include understanding what is it about the processes of Asthma and its treatment that lead to internalizing symptoms,” said Alati, who is a research fellow in the School of Population Health at the University of Queensland in Herston.

Alati said one question is whether there is some interaction between genes and other factors that predisposes some children with asthma to develop psychological problems.

Evidence has been mounting that children with asthma are more likely to have behavior problems than children without the lung disease. But the reason that children with asthma seem prone to internalizing behaviors has been uncertain.

To study the relationship between asthma and behavior, Alati and her colleagues followed more than 5,000 children. At the start of the study, researchers asked mothers whether their children had asthma or bronchitis. Mothers also answered questions about their children’s behavior at age 5. When children were age 14, mothers and the children themselves answered questions about the children’s behavior.

The study did not detect a relationship between asthma and so-called externalizing behaviors, such as frequent arguing, destructive behavior and temper tantrums. But children with asthma were more likely to display internalizing behaviors at age 5 and 14.

The study also found that among 5-year-olds who did not have any internalizing behavior problems, those with asthma were more likely to develop such behaviors by age 14.

If future studies confirm the findings, “clinicians should be encouraged to assess early symptoms of behavior in asthmatic children and provide referrals to appropriate services when necessary,” the team says.

According to Alati, future research should also examine potential differences between boys and girls in the association between asthma and psychological symptoms. Another important question is what can be done to treat or alleviate these behavior symptoms, she added.

SOURCE: Psychosomatic Medicine, May/June 2005.