Adult Asthma, Depression, and Childhood Maltreatment

Depressed little girls sitting on the floor hugging her knees.
Is the presence of asthma in adults who have experienced maltreatment as children mediated by lifetime depressive and/or anxiety disorders?

Generalized anxiety disorder (GAD) and major depression disorder (MDD) partly explain a link between child maltreatment and asthma in adults, according to a study published in the European Respiratory Journal.1

Previous research has demonstrated an association between adverse childhood experiences and adult risk behaviors, health-related quality of life, and chronic diseases such as asthma. Although anxiety and depression have been connected with the pathogenesis of asthma in adults, it is not known whether these conditions facilitate the association between asthma during adulthood in those who experiences maltreatment as children. Thus, researchers examined whether lifetime MDD or lifetime GAD mediate an association between child maltreatment and current asthma. The study involved an analysis of 81,105 British adults in the United Kingdom Biobank who completed a mental health survey and had complete data on child maltreatment, GAD, MDD, asthma, and relevant covariates but no diagnosis of chronic obstructive pulmonary disease.

Through multivariable analysis, the researchers found that any child maltreatment was associated with asthma (adjusted odds ratio [aOR] 1.22; 95% CI, 1.15-1.28; P <.01). When a mediation analysis adjusted for household income, educational attainment, smoking status, pack-years of smoking, and other covariates was conducted, lifetime GAD and lifetime MDD explained 21.8% and 32.5%, respectively, of the child maltreatment-current asthma association; both together explained 38.2% of the observed association. The researchers also found similar results after excluding current smokers and former smokers with 10 or more pack-years of smoking from the mediation analysis.

The authors concluded, “Our findings suggest that GAD and MDD mediate an association

between child maltreatment and asthma in adults, independently of smoking.” They added, “Taken together with a growing body of literature, our results suggest that clinicians caring for adults with asthma should be aware of potential co-morbidities such as depression and anxiety disorders, particularly in those with a history of child maltreatment.”

Authors cited the limitations of their study as possible selection bias resulting from the eligibility requirements used by the researchers and a “’healthy volunteer’ bias” among the UK Biobank database participants that might limit of the generalizability of the study’s findings.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 


Han Y-Y, Yan Q, Chen W, et al. Child maltreatment, anxiety and depression, and asthma among British adults in the UK Biobank. Eur Respir J. Published online March 17, 2022; DOI: 10.1183/13993003.03160-2021).