Asthma and suicide mortality in young people: a 12-year follow-up study.
OBJECTIVE
Mortality risk is relatively high in young people with asthma, and the risk may include causes of death other than those directly linked to respiratory disease. The authors investigated the association between asthma and suicide mortality in a large population-based cohort of young people.


METHODS
A total of 162,766 high school students 11 to 16 years of age living in a catchment area in Taiwan from October 1995 to June 1996 were enrolled in a study of asthma and allergy. Each student and his or her parents completed structured questionnaires. Participants were classified into three groups at baseline: current asthma (symptoms present in the past year), previous asthma (history of asthma but no symptoms in the past year), and no asthma. Participants were followed to December 2007 by record linkage to the national Death Certification System. Cox proportional hazards models were used to study the association between asthma and cause of death.


RESULTS
The incidence rate of suicide mortality in participants with current asthma at baseline was more than twice that of those without asthma (11.0 compared with 4.3 per 100,000 person-years), but there was no significant difference in the incidence of natural deaths. The adjusted hazard ratio for suicide was 2.26 (95% CI=1.43-3.58) in the current asthma group and 1.76 (95% CI=0.90-3.43) in the previous asthma group. Having a greater number of asthma symptoms at baseline was associated with a higher risk of subsequent suicide. The population attributable fraction was 7.0%.


CONCLUSIONS
These results highlight evidence of excess suicide mortality in young people with asthma. There is a need to improve mental health care for young people, particularly those with more severe and persistent asthma symptoms.
Kuo
Chian-Jue
CJ
Institute of Epidemiology, Research Center for Genes, Environment, and Human Health, and Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taiwan.
Chen
Vincent Chin-Hung
VC
Lee
Wen-Chung
WC
Chen
Wei J
WJ
Ferri
Cleusa P
CP
Stewart
Robert
R
Lai
Te-Jen
TJ
Chen
Chiao-Chicy
CC
Wang
Tsu-Nai
TN
Ko
Ying-Chin
YC
D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000401:mortality*; D002423:Cause of Death; D002648:Child; D003644:Death Certificates; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D010290:Parents / Q000523:psychology; D016016:Proportional Hazards Models; D012307:Risk Factors; D012720:Severity of Illness Index; D013405:Suicide / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology