title: Suicidal ideation and suicide attempts in chronic obstructive pulmonary disease: the Korea National Health and Nutrition Examination Survey (KNHANES IV, V) from 2007-2012.
abstract: BACKGROUND
  There is good evidence for an association between chronic obstructive pulmonary disease (COPD) and depression, but there are few studies on the relationship between COPD and suicidal ideation/suicidal attempts.
  
  
  OBJECTIVE
  To evaluate the mental health of patients with COPD in Korea and to compare it with that of the general population.
  
  
  METHODS
  We analysed data of 15,718 subjects (age ⩾40 years) who participated in the 2007-2012 Korea National Health and Nutrition Examination Survey. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria for people aged ⩾40 years. We compared the mental health outcomes of 2,506 patients with COPD (2,355 GOLD stages I and II; 151 GOLD stages III and IV) with those of 13,212 controls.
  
  
  RESULTS
  Suicidal thoughts were reported by 16.0% of patients in stages I and II, by 23.8% of those in stages III and IV and by 15.7% of controls (P=0.023). Suicidal attempts were reported by 0.6% of patients in stages I and II, by 2.6% of those in stages III and IV and by 1.0% of controls (P=0.019). The crude odds ratio (OR) for suicidal ideation in those in stages III and IV was 1.68 (95% confidence interval (CI), 1.16-2.46), and the OR for suicidal attempts in stages III and IV was 2.83 (95% CI, 1.03-7.75). In multivariate analysis, the OR for suicidal ideation in stages III and IV was 1.67 (95% CI, 1.12-2.49) and that for suicidal attempts was 2.94 (95% CI, 1.03-8.31).
  
  
  CONCLUSIONS
  GOLD stages III and IV COPD were associated with a marked increase in suicidal behaviour.
authors.affiliation: Division of Pulmonology, Department of Internal Medicine, International St. Mary`s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Chung
authors.affiliation: Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Koyang, Republic of Korea.
authors.forename: Chang Hoon
authors.initials: CH
authors.lastname: Han
authors.affiliation: Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Koyang, Republic of Korea.
authors.forename: Seon Cheol
authors.initials: SC
authors.lastname: Park
authors.affiliation: Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Koyang, Republic of Korea.
authors.forename: Cheong Ju
authors.initials: CJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D006801:Humans; D009749:Nutrition Surveys; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D056910:Republic of Korea; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D013997:Time Factors