Asthma and Suicide Mortality in Young
People:
A 12-Year Follow-Up Study
Chian-Jue Kuo, M.D., M.S. Vincent Chin-Hung Chen, M.D., Ph.D.
Wen-Chung Lee, M.D., Ph.D. Wei J. Chen, M.D., Sc.D. Cleusa P. Ferri, M.D.,
Ph.D. Robert Stewart, M.D.
Te-Jen Lai, M.D., Ph.D. Chiao-Chicy Chen, M.D., Ph.D. Tsu-Nai Wang, Ph.D.
Ying-Chin Ko, M.D., Ph.D.
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 classifi ed 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 Certifi cation
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 signifi cant 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.
