The relationship between allergic diseases and internalizing and externalizing behaviours in Spanish children: a cross-sectional study

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M Pilar Berzosa-Grande
Eduardo González-Fraile
Rocío Sánchez- López
María Soria-Oliver
Santiago Rueda-Esteban


Allergy, behaviour, internalizing and externalizing, child, parent.


Introduction and objectives: The relationship between allergic diseases and behavioural dis-orders is still unclear. The objective of this study was to describe and compare children’s behaviour (internalising and externalising) across a sample of children aged 6–11 years with and without allergic diseases.

Materials and methods: This was a cross-sectional observational case-control study. A survey to 366 families (194 allergic cases and 172 controls), including a child behaviour checklist (CBCL) and a socio-demographic questionnaire with questions related to family, school education, health conditions and allergy symptoms, was administered.

Results: Children with a diagnosis of allergy showed higher scores in the overall CBCL score (standardised mean differences [SMD] = 0.47;  confidence  intervals  [CI]:  0.26–0.68)  and in the internalising and externalising factors (SMD = 0.52 and SMD = 0.36, respectively) than non-allergic children. Odds ratio (OR) analyses showed a higher risk (OR = 2.76; 95% CI [1.61 to 4.72]) of developing a behavioural difficulty in children diagnosed with allergies. Age and level of asthma appear as modulatory variables. Conclusions: Children aged 6–11 years diagnosed with allergies showed larger behavioural problems than non-allergic children, especially in the case of internalising behaviours. These findings suggest the importance of attending to them and treating them in the early stages of diagnosis to avoid future psychological disorders.

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