Emotional and behavioral problems during preschool years and risk of asthma among children

Previous research has suggested an association between emotional and behavioral problems and asthma in school-aged children. However, research on the relation between emotional and behavioral problems during preschool years and subsequent asthma is lacking. We aimed to estimate the association between emotional and behavioral problems during preschool years and the risk of subsequent asthma among children in Sweden. In this longitudinal cohort study, we used data on children (n = 6269), 3-5 years of age, whose mothers, fathers and/or preschool teachers had responded to the Strengths and Difficulties Questionnaire (SDQ) for assessment of emotional and behavioral problems, and who were followed for a mean of 7 years with regard to asthma diagnoses collected from the National Patient Register. Children identified with emotional symptoms as rated by mothers (hazard ratio [HR]: 1.65, 95% confidence interval [CI]: 1.21-2.25), fathers (HR: 1.50, 95% CI 1.09-2.07) and preschool teachers (HR: 1.55, 95% CI 1.09-2.23) during the preschool years had an increased risk of asthma, compared to children with no emotional symptoms. Conduct problems, peer-relationship problems, and hyperactivity/inattention were not associated with the risk of asthma. Emotional symptoms during preschool years were associated with an increased risk of subsequent asthma. If our findings are replicated by future studies, children with emotional symptoms during preschool years might benefit from interventions targeting both psychological and somatic aspects of asthma.