Clarke Diana E, Goodwin Renee D, Messias Erick L M, Eaton William W
Department of Mental Health, The Johns Hopkins University School of Public Health, Baltimore, Maryland 21205, USA.
Ann Allergy Asthma Immunol. 2008 May;100(5):439-46. doi: 10.1016/S1081-1206(10)60468-1.
Evidence of a respiratory diseases and suicidal ideation and suicide attempts link exists. To improve our understanding of the mechanism underlying these links, there is a need for examination of the relationship between specific respiratory disease, such as asthma, and suicidal ideation and behavior. In addition, studies need to examine many common risk factors that may play a role in the association between asthma and suicidal ideation and suicide behavior.
To examine the association between asthma and suicidal ideation with and without attempts among adults in the United States, specifically investigating the role of cigarette smoking, nicotine dependence, depression, anxiety, and alcohol abuse.
Data on 5,692 individuals 18 years and older were drawn from the US National Comorbidity Survey Replication. Descriptive and multivariate logistic regression analyses were conducted to examine the study objectives.
The estimates of lifetime prevalence for suicidal ideation without and with attempts and asthma were 8.7%, 4.2%, and 12.0%, respectively. Being a woman, a current smoker, depressed, anxious, an alcohol abuser, or nicotine dependent increased the likelihood of suicidal ideation with attempts and asthma. Asthma was significantly (P < .001) associated with suicidal ideation with but not without attempts. Adjustment for smoking, nicotine dependence, age, sex, and race/ethnicity decreased the association between asthma and suicidal ideation with attempts by 16%. Similarly, adjustment for depression, panic disorder, and alcohol abuse led to a 12.4% decrease in this relationship. Despite these adjustments, independently or combined, a statistically significant (P = .02) association remained between asthma and suicidal ideation with attempts.
Cigarette smoking and concurrent mental health conditions may independently account for significant proportions of the association between asthma and suicidal ideation with attempts. More research is needed to further elucidate the mechanism of the remaining association between asthma and suicide attempts. Modification of smoking behaviors and effective treatment of depression, anxiety, alcohol abuse, and possibly asthma are important suicide prevention strategies.
呼吸系统疾病与自杀意念及自杀未遂之间存在关联的证据。为了更好地理解这些关联背后的机制，有必要研究特定呼吸系统疾病（如哮喘）与自杀意念及行为之间的关系。此外，研究还需考察许多可能在哮喘与自杀意念及自杀行为关联中起作用的常见风险因素。
研究美国成年人中哮喘与有或无自杀未遂的自杀意念之间的关联，特别调查吸烟、尼古丁依赖、抑郁、焦虑和酒精滥用的作用。
数据来自美国全国共病调查复制版，涉及5692名18岁及以上个体。进行描述性和多变量逻辑回归分析以检验研究目标。
无自杀未遂、有自杀未遂的自杀意念以及哮喘的终生患病率估计分别为8.7%、4.2%和12.0%。女性、当前吸烟者、抑郁者、焦虑者、酒精滥用者或尼古丁依赖者出现有自杀未遂的自杀意念及哮喘的可能性增加。哮喘与有自杀未遂的自杀意念显著相关（P <.001），但与无自杀未遂的自杀意念无关。对吸烟、尼古丁依赖、年龄、性别和种族/民族进行调整后，哮喘与有自杀未遂的自杀意念之间的关联降低了16%。同样，对抑郁、惊恐障碍和酒精滥用进行调整后，这种关系减少了12.4%。尽管进行了这些调整，但哮喘与有自杀未遂的自杀意念之间无论单独还是综合起来仍存在统计学显著关联（P =.02）。
吸烟和并发的心理健康状况可能分别在很大程度上解释了哮喘与有自杀未遂的自杀意念之间的关联。需要更多研究来进一步阐明哮喘与自杀未遂之间剩余关联的机制。改变吸烟行为以及有效治疗抑郁、焦虑、酒精滥用，可能还有哮喘，是重要的自杀预防策略。
