Chronic stress and asthma in adolescents

Objective To first review and critically discuss published evidence on psychosocial stressors, stress, and asthma in adolescents, and then discuss potential future directions in this field. Data Sources National Library of Medicine (Pubmed). Study Selections A literature search was conducted for human studies on stressors or stress and asthma between 2000 and 2020. Studies that were published in English, contained a full text, and included adolescents were considered for inclusion in this review. Results Compared with the available body of evidence in children and adults, relatively few studies have published in adolescents. Current evidence suggests that exposure to stressors (at the individual, family, and community levels) or stress (acute and chronic) are associated with asthma and worse asthma outcomes, but such evidence must be cautiously interpreted due to limitations in the design or analytical approach of published studies. Conclusion Future large studies with a prospective design should determine whether and how stressors or stress cause or worsen asthma in adolescents. At present, clinicians should assess exposure to stressors (e.g., violence or abuse) and screen for anxiety and depressive disorders when caring for adolescents with asthma, providing referrals to social workers or mental health professionals when appropriate. Public health policies are needed to reduce psychosocial stressors such as gun violence and racism in adolescents.