Kim Sang Hyuk, Lee Hyun, Jung Jin-Hyung, Kim Bo-Guen, Park Dong Won, Park Tai Sun, Moon Ji-Yong, Kim Tae-Hyung, Sohn Jang Won, Yoon Ho Joo, Han Kyungdo, Kim Sang-Heon
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea; Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang Medical Center, Hanyang University College of Medicine, Seoul, Korea.
J Allergy Clin Immunol Pract. 2025 Mar;13(3):559-567.e3. doi: 10.1016/j.jaip.2024.11.013. Epub 2024 Nov 26.
Previous studies have identified an increased risk of suicidal behaviors among individuals with asthma.
To evaluate the long-term risk and factors related to suicide in the adult population with asthma.
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.
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.
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.
既往研究已确定哮喘患者自杀行为风险增加。
评估成年哮喘患者自杀的长期风险及相关因素。
本研究使用韩国国民健康保险服务数据。我们调查了3914041名20岁及以上成年人中有无哮喘与自杀风险及自杀潜在危险因素。
在中位随访12.3年（四分位间距，12.1 - 12.6年）期间，1383名（0.48%）哮喘患者自杀死亡。与对照组相比，哮喘患者自杀风险增加（校正风险比[aHR]，1.26；95%置信区间[CI]，1.19 - 1.33）。哮喘特定表型患者自杀风险尤其高：易住院型（aHR，1.61；95% CI，1.40 - 1.84）、非肥胖型（aHR，1.37；95% CI，1.27 - 1.64）以及哮喘 - 慢性阻塞性肺疾病重叠型（aHR，1.47；95% CI，1.22 - 1.76）。并存体重过轻状态（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]和焦虑症[aHR，2.47；95% CI，2.00 - 3.05]）以及癌症（aHR，2.22；95% CI，1.73 - 2.84）会进一步增加自杀风险。
哮喘与自杀风险增加相关，尤其是在易住院型、非肥胖型以及哮喘 - 慢性阻塞性肺疾病重叠型表型患者中。当哮喘与体重过轻状态、精神健康障碍或癌症并存时，风险会进一步增加。
