Background: The prognosis of chronic somatic diseases in children is determined not only by biological factors but also by the psychosocial environment. Chronic psychosocial stress (family conflict, academic pressure, social isolation) is known to dysregulate the immune system via the hypothalamic-pituitary-adrenal axis. Conversely, strong social integration is hypothesized to have a "buffering effect." This study aims to quantify the impact of psychosocial stress and social integration on the clinical course and prognosis of children with Bronchial Asthma (BA) and Recurrent Respiratory Infections (RRI). Methods: A prospective cohort study involving 250 children (aged 7–14 years) with diagnosed BA or RRI was conducted in the Andijan region. Psychosocial status was assessed using the "Perceived Stress Scale for Children" (PSS-C) and "Child and Adolescent Social Support Scale" (CASSS). Clinical prognosis was measured by the frequency of exacerbations, duration of remission, and hospitalization rates over a 12-month follow-up period. Results: Children with high psychosocial stress levels experienced a 2.5-fold increase in disease exacerbations compared to the low-stress group (p < 0.001). Low social integration scores significantly correlated with prolonged recovery times and resistance to standard therapy. High levels of family and peer support were associated with a 40% reduction in the risk of severe complications. Conclusion: Psychosocial stress is a potent non-infectious risk factor that worsens the prognosis of pediatric diseases. Enhancing social integration and reducing environmental stressors are essential components of comprehensive pediatric care.

Psychosocial stress, social integration, pediatric diseases, bronchial asthma, prognosis, psychoneuroimmunology, quality of life.

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