Asthma and Suicide Mortality in Young People: A 12-Year Follow-Up Study
Asthma and Suicide Mortality in Young People: A 12-Year Follow-Up Study
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DOI：
10.1176/appi.ajp.2010.09101455
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发表时间：
2010-09-01
影响因子：
17.7
通讯作者：
Ko, Ying-Chin
中科院分区：
文献类型：
--
作者：
Kuo, Chian-Jue;Chen, Vincent Chin-Hung;Ko, Ying-Chin
目的：年轻哮喘患者的死亡风险相对较高，风险可能包括与呼吸系统疾病直接相关以外的死亡原因。作者在一个以人口为基础的年轻人队列中调查了哮喘和自杀死亡率之间的关系。方法：对1995年10月~ 1996年6月居住在台湾某集水区的11 ~ 16岁高中生162,766人进行哮喘与过敏研究。每位学生及其父母都完成了结构化的问卷调查。参与者在基线时分为三组：当前哮喘（过去一年出现症状）、既往哮喘（过去一年有哮喘病史但无症状）和无哮喘。通过与国家死亡证明系统的记录联系，跟踪参与者至2007年12月。采用Cox比例风险模型研究哮喘与死亡原因之间的关系。结果：基线时患有哮喘的参与者的自杀死亡率是没有哮喘的参与者的两倍多（11.0比4.3 / 100000人年），但自然死亡的发生率没有显著差异。当前哮喘组的自杀校正风险比为2.26 (95% CI=1.43-3.58)，前哮喘组的自杀校正风险比为1.76 （95% CI=0.90-3.43）。基线时哮喘症状越多，随后自杀的风险越高。总体归因率为7.0%。结论：这些结果强调了年轻哮喘患者自杀死亡率过高的证据。有必要改善年轻人的精神卫生保健，特别是那些有更严重和持续哮喘症状的年轻人。
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.Method: 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.