文章基本信息

标题：Asthma, Suicidal Ideation, and Suicide Attempts: Findings From the Baltimore Epidemiologic Catchment Area Follow-Up
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作者：Renee D. Goodwin ; William W. Eaton
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2005
卷号：95
期号：4
页码：717-722
DOI：10.2105/AJPH.2003.019109
语种：English
出版社：American Public Health Association
摘要：Objectives. We examined cross-sectional and longitudinal associations between asthma, suicidal ideation, and suicide attempt among adults in the community. Methods. Data were drawn from 3 waves (1981,1982,1993–1996) of the Baltimore follow-up of the Epidemiologic Catchment Area study. Multiple logistic regression analyses were used to examine associations between asthma, asthma treatment, suicidal ideation, suicide attempt, and suicide completion. Results. Asthma at wave 1 was associated with a significantly increased odds of suicidal ideation (odds ratio [OR] = 2.33; confidence interval [CI] = 1.03, 5.25) and suicide attempt (OR=3.54; CI=1.4, 8.99), which persisted independent of lifetime National Institute of Mental Health Diagnostic Interview Schedule/ Diagnostic and Statistical Manual of Mental Disorders, Third Edition major depression and treatment for asthma at wave 2. Conclusions. These findings provide preliminary evidence suggestive of an association between asthma and an increased likelihood of suicidal ideation and suicide attempt among adults in the community. Neither lifetime major depression nor treatment for asthma explained this relation. These results provide important directions for future research, and if replicated these data may have clinical and public health implications. Recent data from general medical inpatient and outpatient samples suggest that asthma is associated with increased likelihood of suicidal ideation. 1– 5 These findings are consistent with results suggesting that chronic physical illness is associated with higher-than-expected rates of suicidal ideation, specifically with evidence of a link between respiratory disease and suicidal ideation and suicidal behavior in medical care and community-based samples. 3– 5 The observed association between asthma and suicidal ideation is also consistent with a previously documented link between asthma and major depression. 6, 7 In sum, although previous findings suggest that asthma is associated with increased likelihood of suicidal ideation, several methodological features of previous studies limit their generalizability for at least 4 reasons. First, with 1 exception, 1 studies to date have been conducted exclusively with clinical samples. 4, 5 Therefore, it is not clear whether or to what extent the relation between asthma and suicidal ideation is associated with factors linked with selection into treatment, or whether this reflects a true exposure-disease relation. Second, previous studies have been limited to the use of cross-sectional data. 1– 7 Therefore, conclusions about the direction of effect or sequence of onset of disorders, which would be critical to the development of intervention strategies, cannot be drawn. Third, previous studies have examined the relation between asthma and suicidal ideation 1, 3 but have not included data on the relation between asthma and suicide completion. Fourth, several previous studies have found a link between respiratory disease and suicidal ideation and suicide attempts, 3, 4 but data have not been specific to asthma, so it has not been possible to draw conclusions about asthma and suicidal behavior per se. The goal of our study was to determine the cross-sectional and longitudinal associations between (1) asthma and suicidal ideation and (2) asthma and suicidal behavior among adults in the community. We hypothesized that asthma would be associated with a significantly increased risk of suicidal ideation and suicidal behavior among adults in the community.