Interaction effects of asthma severity and control on the mental health of children with asthma: findings from a South-Eastern Nigeria Tertiary Hospital

Asthma severity and control are important drivers of asthma burden, and they impart negatively on the mental health of Children with Asthma (CwA). Unfortunately, knowledge gaps exist on how asthma severity and control interact with the mental health of these children. To determine whether the effect of worsening asthma severity on the mental health of CwA attending a South-Eastern Nigeria Tertiary Hospital is dependent on the effect of poor asthma control. This cross-sectional analytical survey recruited 101 CwA aged 6–17 years and 101 age- and sex-matched controls. The mental health of both groups was determined using the Strengths and Difficulties Questionnaire (SDQ). Asthma severity and control among the CwA were determined using the Asthma Severity Scale and Asthma Control Test, respectively. The formulated hypothesis was tested at P < 0.05. Interaction effects of asthma severity and control on mental health were determined using a multivariate logistic regression model. The median SDQ score of the CwA was significantly higher than that of controls ( P = 0.001). There were no significant interaction effects of asthma severity and control on the mental health of the CwA, as no significant relationship existed between Mental Health Problems (MHP) and asthma severity (adjusted Odds ratio [aOR] = 8.13; 95% CI = 0.85–101.17; p = 0.10). Only asthma control showed a significant effect on mental health, as the children with poorly controlled asthma had higher odds of developing MHP (aOR = 4.08, 95% CI = 1.03–16.13, p = 0.04). There is no interaction effect of asthma severity and control on the mental health of CwA, as MHP was only associated with poor asthma control, irrespective of asthma severity. This informs the need for child mental health services to be integrated into the existing asthma management programs.