Asthma Increases Long-Term Risk of Death by Suicide: A Nationwide Population-Based Cohort Study

IF 8.2 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-03-01 DOI:10.1016/j.jaip.2024.11.013

Sang Hyuk Kim MD , Hyun Lee MD, PhD , Jin-Hyung Jung PhD , Bo-Guen Kim MD, PhD , Dong Won Park MD, PhD , Tai Sun Park MD, PhD , Ji-Yong Moon MD, PhD , Tae-Hyung Kim MD, PhD , Jang Won Sohn MD, PhD , Ho Joo Yoon MD, PhD , Kyungdo Han PhD , Sang-Heon Kim MD, PhD

{"title":"Asthma Increases Long-Term Risk of Death by Suicide: A Nationwide Population-Based Cohort Study","authors":"Sang Hyuk Kim MD , Hyun Lee MD, PhD , Jin-Hyung Jung PhD , Bo-Guen Kim MD, PhD , Dong Won Park MD, PhD , Tai Sun Park MD, PhD , Ji-Yong Moon MD, PhD , Tae-Hyung Kim MD, PhD , Jang Won Sohn MD, PhD , Ho Joo Yoon MD, PhD , Kyungdo Han PhD , Sang-Heon Kim MD, PhD","doi":"10.1016/j.jaip.2024.11.013","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have identified an increased risk of suicidal behaviors among individuals with asthma.</div></div><div><h3>Objective</h3><div>To evaluate the long-term risk and factors related to suicide in the adult population with asthma.</div></div><div><h3>Methods</h3><div>This study used the Korean National Health Insurance Service data. We investigated the risk of suicide concerning the presence or absence of asthma and potential risk factors for suicide among 3,914,041 adults aged 20 years or more.</div></div><div><h3>Results</h3><div>During a median follow-up of 12.3 years (interquartile range, 12.1-12.6 years), 1383 (0.48%) individuals with asthma died by suicide. Individuals with asthma had an increased risk of suicide compared with controls (adjusted hazard ratio [aHR], 1.26; 95% CI, 1.19-1.33). Suicide risk was especially high in individuals with asthma phenotypes: hospitalization-prone (aHR, 1.61; 95% CI, 1.40-1.84), nonobese (aHR, 1.37; 95% CI, 1.27-1.64), and asthma-chronic obstructive pulmonary disease overlap (aHR, 1.47; 95% CI, 1.22-1.76). Coexisting underweight status (aHR, 2.54; 95% CI, 2.05-3.16), mental health disorders (schizophrenia [aHR, 3.38; 95% CI, 2.28-5.02], depression [aHR, 3.24; 95% CI, 2.85-3.68], and anxiety disorder [aHR, 2.47; 95% CI, 2.00-3.05]), and cancers (aHR, 2.22; 95% CI, 1.73-2.84) further increased the suicide risk.</div></div><div><h3>Conclusions</h3><div>Asthma was associated with an increased risk of suicide, particularly in hospitalization-prone, nonobese, and asthma-chronic obstructive pulmonary disease overlap phenotypes. The risk was further increased when asthma coexisted with underweight status, mental health disorders, or cancers.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"13 3","pages":"Pages 559-567.e3"},"PeriodicalIF":8.2000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Allergy and Clinical Immunology-In Practice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213219824011784","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ALLERGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Previous studies have identified an increased risk of suicidal behaviors among individuals with asthma.

Objective

To evaluate the long-term risk and factors related to suicide in the adult population with asthma.

Methods

This study used the Korean National Health Insurance Service data. We investigated the risk of suicide concerning the presence or absence of asthma and potential risk factors for suicide among 3,914,041 adults aged 20 years or more.

Results

During a median follow-up of 12.3 years (interquartile range, 12.1-12.6 years), 1383 (0.48%) individuals with asthma died by suicide. Individuals with asthma had an increased risk of suicide compared with controls (adjusted hazard ratio [aHR], 1.26; 95% CI, 1.19-1.33). Suicide risk was especially high in individuals with asthma phenotypes: hospitalization-prone (aHR, 1.61; 95% CI, 1.40-1.84), nonobese (aHR, 1.37; 95% CI, 1.27-1.64), and asthma-chronic obstructive pulmonary disease overlap (aHR, 1.47; 95% CI, 1.22-1.76). Coexisting underweight status (aHR, 2.54; 95% CI, 2.05-3.16), mental health disorders (schizophrenia [aHR, 3.38; 95% CI, 2.28-5.02], depression [aHR, 3.24; 95% CI, 2.85-3.68], and anxiety disorder [aHR, 2.47; 95% CI, 2.00-3.05]), and cancers (aHR, 2.22; 95% CI, 1.73-2.84) further increased the suicide risk.

Conclusions

Asthma was associated with an increased risk of suicide, particularly in hospitalization-prone, nonobese, and asthma-chronic obstructive pulmonary disease overlap phenotypes. The risk was further increased when asthma coexisted with underweight status, mental health disorders, or cancers.

查看原文本刊更多论文

哮喘增加自杀死亡的长期风险：一项基于全国人群的队列研究

背景：先前的研究已经确定哮喘患者自杀行为的风险增加。目的：评估成人哮喘患者自杀的长期危险及相关因素。方法：本研究采用韩国国民健康保险服务的数据。我们调查了3,914,041名年龄≥20岁的成年人的自杀风险，包括是否存在哮喘和潜在的自杀危险因素。结果：在中位随访12.3年（四分位数间距12.1-12.6年）期间，1383例（0.48%）哮喘患者自杀身亡。与对照组相比，哮喘患者的自杀风险增加（校正风险比[aHR] = 1.26, 95%可信区间[CI] = 1.19-1.33）。有哮喘表型的个体自杀风险特别高：住院倾向（aHR = 1.61, 95% CI = 1.40-1.84）、非肥胖（aHR = 1.37, 95% CI = 1.27-1.64）和哮喘-慢性阻塞性肺疾病重叠（ACO）（aHR = 1.47, 95% CI = 1.22-1.76）。同时存在的体重不足状况（aHR = 2.54, 95% CI = 2.05-3.16）、精神健康障碍（精神分裂症[aHR = 3.38, 95% CI = 2.28-5.02]、抑郁症[aHR = 3.24, 95% CI = 2.85-3.68]、焦虑症[aHR = 2.47, 95% CI = 2.00-3.05]）和癌症（aHR = 2.22, 95% CI = 1.73-2.84）进一步增加了自杀风险。结论：哮喘与自杀风险增加有关，特别是在住院倾向、非肥胖和ACO表型中。当哮喘与体重不足、精神健康障碍或癌症共存时，风险进一步增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Allergy and Clinical Immunology-In Practice ALLERGYIMMUNOLOGY-IMMUNOLOGY

CiteScore

11.10

自引率

9.60%

发文量

683

审稿时长

50 days

期刊介绍： JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases. This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders. The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.