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Huang YH, Chiou HC, Pan CH, Wang IS, Liao YT, Su SS, Chen CC, Kuo CJ. Healthcare Utilization, Physical and Psychiatric Comorbidities Before Self-Injurious Behavior in Patients with Asthma: A Nested Case-Control Study. J Asthma Allergy 2024; 17:411-420. [PMID: 38736905 PMCID: PMC11088374 DOI: 10.2147/jaa.s449337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 04/30/2024] [Indexed: 05/14/2024] Open
Abstract
Background Patients with asthma experience more physical, psychological, and financial burdens; a link between asthma and suicidality has been reported in research. Purpose This study analyzed the medical utilization and comorbidity before their self-injurious behavior in patients with asthma. Methods We enrolled 186,862 patients newly diagnosed with asthma between 1999 and 2013 from the National Health Insurance Research Database in Taiwan. A total of 500 case subjects had ever conducted self-injurious behaviors during the study period. Based on a nested case-control study, each case was matched with 10 controls derived from the asthma cohort to analyze differences between them and their medical use models. Results The results indicated that, compared to the control group, the cases presented higher frequencies of outpatient visits and hospitalizations. Regarding comorbidity, the cases had more cardiovascular diseases (adjusted odds ratio [aOR]=1.58; p<0.001), bipolar disorder (aOR=2.97; p<0.001), depression (aOR=4.44; p<0.001), and sleep disorder (aOR=1.83; p<0.001) than the controls. Conclusion The evidence-based information serves as a reference for medical staff to reduce the occurrence of self-injurious behavior in patients with asthma.
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Affiliation(s)
- Yen-Hsun Huang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Hsien-Chih Chiou
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Chun-Hung Pan
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - I-Shuan Wang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Ya-Tang Liao
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Sheng-Siang Su
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Chiao-Chicy Chen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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Varshney K, Shet P, George B, Wintersteen M. Does Asthma Increase the Odds of Suicidal Thoughts, Plans, and Attempts? Cureus 2024; 16:e53865. [PMID: 38465093 PMCID: PMC10924673 DOI: 10.7759/cureus.53865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Background Asthma is a chronic inflammatory disease of the airways affecting more than 250 million people worldwide. In the past, a possible relationship between asthma and suicidality has been hypothesized. However, further research is required as this link has not been clearly established. Our objective was to use propensity score matching to answer the following research question: does having asthma increase one's odds of developing suicidality throughout their lifetime and, if so, how large is this increase? Methodology We utilized data from the 2018 National Survey on Drug Use and Health. We analyzed the relationship between currently having asthma and having had suicidal thoughts, suicide plans, and suicide attempts over the past 12 months. Chi-square analyses were performed both before and after completing propensity score matching. Results Before matching, it was found that, compared to individuals without asthma, asthmatic individuals had 31.2% higher odds of having suicidal thoughts (p = 0.010) and 97.4% higher odds of a suicide attempt (p = 0.012). After controlling for confounders by matching, there was no longer a relationship between having asthma and suicidal thoughts (p = 0.707), suicidal plans (p = 0.523), and suicidal attempts (p = 0.260). Conclusions These findings highlight that while asthma may appear to be associated with suicidality, this association does not persist after controlling for confounding factors. Hence, it is recommended that more research be conducted on this topic and that possible confounders be further researched. In particular, there is a need to better understand the role of social determinants and other contributors to health outcomes.
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Affiliation(s)
- Karan Varshney
- Public Health, School of Medicine, Deakin University, Waurn Ponds, AUS
| | - Pavan Shet
- Internal Medicine, School of Medicine, Deakin University, Waurn Ponds, AUS
| | - Brandon George
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, USA
| | - Matthew Wintersteen
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA
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Courtwright SE, Jones J, Barton A, Peterson K, Eigen K, Feuerstein J, Pawa A, Pawa A, Northridge J, Pall H. Including Voices of Adolescents With Chronic Conditions in the Redesign of Children's Mental Health Systems: Implications for Resource Allocation. J Pediatr Health Care 2023. [PMID: 36863886 DOI: 10.1016/j.pedhc.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
INTRODUCTION Adolescents with chronic conditions have disparate mental health outcomes. This study aimed to explore the perspectives of adolescents with chronic conditions on mental health system redesign to improve outcomes. METHOD Within an interpretive phenomenological approach, semistructured interviews with 17 adolescents aged 10-20 years with chronic conditions were conducted. Purposive sampling and recruitment occurred at three ambulatory sites. Data were analyzed using inductive and deductive thematic analysis until information saturation was achieved. RESULTS Four themes were identified: (1) Brushed off: I need to be heard, (2) I need someone I can really talk to and trust, (3) They need to reach out to us. Check in on us, and (4) the school nurse is for physical illness only. DISCUSSION Mental health system redesign should be considered for adolescents with chronic conditions. The findings can inform future research to test innovative health care delivery models to reduce mental health disparities in this vulnerable population.
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Affiliation(s)
- Suzanne E Courtwright
- Suzanne E. Courtwright, Postdoctoral Research Fellow, College of Nursing, University of Colorado, Aurora, CO; Center for Healthcare Delivery Research and Innovations, Columbia University School of Nursing, New York, NY.
| | - Jacqueline Jones
- Jacqueline Jones, Professor of Nursing, Assistant Dean and PhD Program Director, College of Nursing, University of Colorado, Aurora, CO
| | - Amy Barton
- Amy Barton, Professor, Senior Associate Dean for Faculty and Students, Daniel and Janet Mordecai Endowed Chair in Rural Health Nursing, College of Nursing, University of Colorado, Aurora, CO
| | - Kerry Peterson
- Kerry Peterson, Associate Professor, Specialty Director of the PMHNP program, University of Colorado, Aurora, CO
| | - Karen Eigen
- Karen Eigen, Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ; Pediatric Emergency Medicine Physician, Department of Emergency Medicine, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ
| | - Jessica Feuerstein
- Jessica Feuerstein, Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ; Pediatrician, Departments of Emergency Medicine and Adolescent Medicine, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ, and Pediatrician; Department of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Anil Pawa
- Anil Pawa, Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ; Chair of Pediatrics, and Professor, Section Chief, Primary Care Pediatrics, Department of Pediatrics, K. Hovnanian Children's Hospital, Jersey Shore University Medical Center, Neptune, NJ
| | - Akhil Pawa
- Akhil Pawa, Research Assistant, Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ; Research Assistant, Department of Emergency Medicine, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ
| | - Jessica Northridge
- Jessica Northridge, Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ; Section Chief, Adolescent Medicine, Department of Emergency Medicine, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ
| | - Harpreet Pall
- Harpreet Pall, Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ; Chair of Pediatrics, and Professor, Department of Pediatrics, K. Hovnanian Children's Hospital, Jersey Shore University Medical Center, Neptune, NJ
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4
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[Asthma and suicidal behavior in adolescents: a literature review]. Rev Mal Respir 2022; 39:344-366. [PMID: 35459587 DOI: 10.1016/j.rmr.2021.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/21/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Adolescence is a difficult time in life and asthma has major psychological consequences for adolescents. OBJECTIVES This systematic literature review focused on the association between asthma and suicidal behaviors (suicidal ideations [SI], suicide plans [SP] and suicide attempts [SA]) among adolescents in the general population. METHOD Research on Medline for the 1980-2021 period. Objectives This systematic literature review focused on the association between asthma and suicidal behaviors (suicidal ideations [SI], suicide plans [SP] and suicide attempts [SA]) among adolescents in the general population. RESULTS An overwhelming majority of the studies taken into consideration demonstrated a significant positive association between asthma and suicidal behaviors. Among the 10 studies assessing SI (with or without SP), 9 of them found a significant positive association between asthma and SI. Eight studies assessed SA; five cross-sectional studies and one prospective study demonstrated a significant positive association between asthma and SA. Only one case-control study did not find a significant positive association between asthma and SA after hospitalization for asthma. The two cross-sectional studies assessing suicidal risk taken as a whole (SI, SP and SA) demonstrated a significant positive association between asthma and at least one suicidal behavior. (OR=1.71; P<0.001). However, several studies did not include depression as an adjustment factor. CONCLUSION It is important that healthcare professionals assess suicide risk in adolescent suffering from asthma, the objective being to avoid SA or death from SA.
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Kyung Y, Han YJ, Lee JS, Lee JH, Jo SH, Kim SH. Evaluation of changing trend in depression, suicidal ideation, and suicide attempts among adolescents with asthma and identification of associated factors: 11-year national data analysis in 788,411 participants. J Asthma 2020; 58:921-931. [PMID: 33158389 DOI: 10.1080/02770903.2020.1847930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES We identified associated factors for depression and suicidality in adolescents with asthma. METHODS We obtained data from the annual Korea Youth Risk Behavior Web-based Surveys, completed from 2007 to 2017, as a stratified, multistage, clustered sample. Using self-reported questionnaires, students provided yes-or-no answers to questions addressing doctor-diagnosed asthma and self-experienced depression and suicidality. Associated factors for depression and suicidality were tested by logistic regression models after controlling for potential confounding factors. A total of 788,411 adolescents completed the survey. RESULTS The prevalence of asthma was similar every year during the survey with 8.9% overall rate. Among them, the prevalence of depression (45.8-29.9%), suicidal ideation (28.6-15.5%), and suicide attempts (9.3-3.9%) decreased. Participants with asthma perceived themselves as unhealthier and unhappier, had more stress, sleep dissatisfaction, depression, suicidal ideation and suicide attempts than did subjects without asthma. In the multivariate model, perception of stress was most strongly associated with depression (adjusted Odds ratio: 4.78, 95% confidence intervals; 4.17-5.06) and suicide attempts (2.51; 1.67-2.93), whereas, perceived unhappiness was most strongly associated with suicidal ideation (4.81; 3.87-5.46) among adolescents with asthma. Asthma itself was also associated with depression, suicidal ideation and suicide attempts (1.12; 1.09-1.22, 1.18; 1.07-1.24, and 1.15; 1.04-1.19, respectively). CONCLUSION Although the prevalence of asthma was similar every year, the prevalence of depression and suicidality among adolescents with asthma decreased. Nevertheless, clinical physicians should pay more attention to screen for depression and suicidality among adolescents with asthma, especially having associated factors.
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Affiliation(s)
- Yechan Kyung
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Young Joo Han
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Jun Hwa Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Seon Hui Jo
- Department of Biostatistics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Sung Hoon Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
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Adewuya AO, Oladipo EO. Prevalence and associated factors for suicidal behaviours (ideation, planning, and attempt) among high school adolescents in Lagos, Nigeria. Eur Child Adolesc Psychiatry 2020; 29:1503-1512. [PMID: 31858265 DOI: 10.1007/s00787-019-01462-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 12/13/2019] [Indexed: 12/28/2022]
Abstract
To plan effective school-based adolescent suicide prevention strategies, there is need for valid epidemiology data. The aim of this study was to estimate the current (1 month) prevalence and associated factors of suicidal behaviours (ideation, planning, and attempt) amongst secondary school adolescents in Lagos, Nigeria. A total of 9441 adolescents (4684 males and 4757 females) with mean age 15.61 years (SD 1.49) recruited from 47 public senior secondary schools self-completed questionnaire consisting of sociodemographic, family, school, physical health, and mental health-related variables. Suicidal behaviours (ideation, planning, and attempt) in the past 1 month were also assessed. The weighted 1-month prevalence for suicidal ideation was 6.1% (95% CI 5.5-6.7), suicidal planning was 4.4% (95% CI 3.8-4.9), and suicidal attempt was 2.8% (95% CI 2.4-3.2). The factors significantly associated with suicidal behaviours included being female, not staying with the mother, maternal drinking, witnessing domestic violence, past and present academic difficulties, having no close friend in school and having problems relating with peers and teachers. Also, presence of chronic physical illnesses, depression, anxiety, behavioural disorders, and psychotic-like experiences were associated with adolescent suicidal behaviour. We have shown that a substantial percentage of adolescent have suicidal behaviours, and that there were demographic, family, school, physical health, and psychological health-related factors. We believe that our findings will be important when planning suicide prevention services that could be incorporated into the school mental health services.
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Affiliation(s)
- Abiodun O Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria. .,Centre for Mental Health Research and Initiative (CEMHRI), Ikeja, Lagos, Nigeria.
| | - Eniola O Oladipo
- Centre for Mental Health Research and Initiative (CEMHRI), Ikeja, Lagos, Nigeria
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7
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Kim JS, Seo Y. Allergic Disease, Short Sleep Duration, and Suicidal Ideation and Plans Among Korean Adolescents. J Sch Nurs 2020; 38:173-183. [PMID: 32347162 DOI: 10.1177/1059840520921920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of the study is to identify the relationships between allergic disease, suicidal ideation, and plans among Korean adolescents. Additionally, we examined the mediating role of short sleep duration. We analyzed nationally representative cross-sectional data from the 12th to 14th Korea Youth Risk Behavior Web-Based Survey; the final sample included 164,725 middle school-aged and high school-aged adolescents (mean age = 15.17 years, standard deviation = .13; 51.1% male). Allergic disease was a statistically significant risk factor for suicidal ideation (crude odds ratio [COR] = 1.284, 95% confidence interval [CI] = [1.246, 1.323]) and suicide plans (COR = 1.165, 95% CI = [1.108, 1.224]). Short sleep duration was a statistically significant mediator (p < .001). We advised school nurses to assess warning signs of poor sleep-including irritability, depression, sleep problems, poor concentration, and poor academic achievement-and that programs be created to improve sleep and mental health in adolescents with allergic disease.
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Affiliation(s)
- Ji-Su Kim
- Department of Nursing, Graduate School, Chung-Ang University, Seoul, Republic of Korea
| | - Yeji Seo
- Department of Nursing, Graduate School, Chung-Ang University, Seoul, Republic of Korea
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8
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Shankar M, Fagnano M, Blaakman SW, Rhee H, Halterman JS. Depressive Symptoms Among Urban Adolescents with Asthma: A Focus for Providers. Acad Pediatr 2019; 19:608-614. [PMID: 30578922 PMCID: PMC6586550 DOI: 10.1016/j.acap.2018.12.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 12/09/2018] [Accepted: 12/14/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Asthma is the most common chronic disease of childhood in the United States, disproportionately affecting urban, poor, and minority children. Adolescents are at high risk for poor asthma outcomes and for depressive symptoms. The purpose of this study is to investigate associations between depressive symptoms and asthma-related clinical and functional outcomes among urban teens. METHODS We used baseline data from a 3-arm randomized trial, School-Based Asthma Care for Teens, in Rochester, NY. We used the Center for Epidemiological Studies Depression Scale with a standard cutoff score of 16 to identify subjects at risk for clinical depression. We used structured in-home surveys and validated scales to assess clinical and functional outcomes and conducted bivariate and multivariate analyses to evaluate differences between groups. RESULTS We identified 277 eligible teens (ages 12 to 16, 80% participation, 54% black, 34% Hispanic, 45% female, 84% on Medicaid). Overall, 28% reported depressive symptoms. Teens with depressive symptoms experienced greater asthma symptom severity and more acute health care utilization for asthma (all P < .001); however, there was no difference in preventive care use between groups. Teens with depressive symptoms also reported lower asthma-related quality of life (P < .001), less sleep (P < .001), and more limitation in mild (adjusted odds ratio [aOR], 2.60; 95% confidence interval [CI], 1.34-5.02) and moderate (aOR, 2.56; 95% CI, 1.41-4.61) activity and in gym (aOR, 2.33; 95% CI, 1.30-4.17). CONCLUSIONS Depressive symptoms are prevalent among urban teens with asthma and are associated with worse asthma-related clinical outcomes, functional limitation, and quality of life. Providers should consider depression as a significant comorbidity that may impact multiple aspects of daily life for this population.
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Affiliation(s)
- Michelle Shankar
- University of Rochester Department of Pediatrics, Division of General Pediatrics, 601 Elmwood Avenue Box 777, Rochester, NY 14642, USA
| | - Maria Fagnano
- University of Rochester Department of Pediatrics, Division of General Pediatrics, 601 Elmwood Avenue Box 777, Rochester, NY 14642, USA
| | - Susan W. Blaakman
- University of Rochester Department of Pediatrics, Division of General Pediatrics, 601 Elmwood Avenue Box 777, Rochester, NY 14642, USA
- University of Rochester School of Nursing, 255 Crittenden Blvd, Rochester, NY 14620, USA
| | - Hyekyun Rhee
- University of Rochester School of Nursing, 255 Crittenden Blvd, Rochester, NY 14620, USA
| | - Jill S. Halterman
- University of Rochester Department of Pediatrics, Division of General Pediatrics, 601 Elmwood Avenue Box 777, Rochester, NY 14642, USA
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Han YY, Forno E, Celedón JC. Health risk behaviors, violence exposure, and current asthma among adolescents in the United States. Pediatr Pulmonol 2019; 54:237-244. [PMID: 30614209 PMCID: PMC7032019 DOI: 10.1002/ppul.24236] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/27/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Asthma may worsen during adolescence, due to both health risk behaviors and psychosocial stressors commonly encountered during this life stage. METHODS Cross-sectional study of 24 612 high school students who participated in the 2009 and 2011 National Youth Risk Behavior Survey. Multivariable logistic regression was used to examine the relation between self-reported health risk behaviors or psychosocial stressors and current asthma. Mediation analysis was performed to assess whether depressive symptoms or suicidal behavior contribute to the link between psychosocial stressors and asthma. RESULTS Current asthma was reported by 13.1% of the study participants. In a multivariable analysis, female sex, obesity, shorter sleep duration, frequent soda/pop consumption, and marijuana use were each significantly associated with 14-36% increased odds of asthma. Any violent behavior (adjusted odds ratio [OR] = 1.12, 95% confidence interval [CI] = 1.02-1.24), any victimization (OR = 1.43, 95%CI = 1.29-1.58), any suicidal behavior (OR = 1.41, 95%CI = 1.22-1.64) and having felt sad or hopeless in the past year (OR = 1.57, 95%CI = 1.40-1.75) were each associated with current asthma. In a mediation analyses, having felt sad/hopeless and suicidal behaviors accounted for 21% and 14%, respectively, of the victimization-asthma association. CONCLUSION Potentially modifiable risk factors, including obesity, short sleep duration, frequent soda/pop consumption, and psychosocial stressors are associated with asthma in US adolescents. Promoting healthier lifestyles, as well as screening for violence exposure and treating depressive symptoms, could help reduce asthma burden in this population.
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Affiliation(s)
- Yueh-Ying Han
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erick Forno
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
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Vargas PA, Robles E. Asthma and allergy as risk factors for suicidal behavior among young adults. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:97-112. [PMID: 29652637 DOI: 10.1080/07448481.2018.1462822] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/15/2018] [Accepted: 04/05/2018] [Indexed: 06/08/2023]
Abstract
UNLABELLED An association between allergic disease, depression and suicidality has been reported. OBJECTIVE To explore the relationships between suicidality and asthma, allergy, internet addiction, stress, sleep quality, pain/discomfort, and depression, among emerging adults. PARTICIPANTS 929 college students completed an online survey between October 2015 and April 2017. METHODS A cross-sectional study using multivariate analysis techniques was implemented. RESULTS Using structural equation modeling, we found that allergies and stress were directly related to pain/discomfort; pain/discomfort was associated to poor sleep, depression, and suicidality. Sleep quality was also affected by stress; while sleep, stress, pain/discomfort, and internet addiction were directly related to depression (all p < .05). Ultimately, four factors impacted suicidality: stress, pain/discomfort, depression, and, indirectly, sleep quality (all p < .05). Although allergy had some effects, these did not reach statistical significance (p < .09). CONCLUSION Findings suggest that allergy might impact suicidality indirectly through increased pain/discomfort, poor sleep, and depression.
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Affiliation(s)
- Perla A Vargas
- a School of Social and Behavioral Sciences, Arizona State University , Glendale , Arizona , USA
| | - Elias Robles
- a School of Social and Behavioral Sciences, Arizona State University , Glendale , Arizona , USA
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Wu Y, Yue J, Wu J, Zhou W, Li D, Ding K, Barnie PA, Xu X, Xu H, Shi W. Obesity May Provide Pro-ILC3 Development Inflammatory Environment in Asthmatic Children. J Immunol Res 2018; 2018:1628620. [PMID: 30622974 PMCID: PMC6304845 DOI: 10.1155/2018/1628620] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 08/27/2018] [Accepted: 09/25/2018] [Indexed: 02/07/2023] Open
Abstract
The prevalence of obesity in children has dramatically increased in the last few decades, and obesity has also emerged as an important risk factor for asthma. Innate mechanisms have been shown to be involved in both diseases, particularly through the recently described innate lymphoid cells (ILCs), in which ILC3s have been linked to obesity both in human and in murine models. The aim of this study was to explore whether being overweight in asthmatic children was associated with elevated circulating ILC3 or elevated messenger RNA (mRNA) levels of RORC, IL-17A, and IL-22. Our results showed significantly elevated ILC3 frequencies in overweight asthmatic children compared with nonoverweight controls based on the detection of Lin+CD127+IL-23R+ cells by flow cytometry. Moreover, elevated ILC3 frequencies positively correlated with the mRNA expression of RORC which has been identified as a transcription factor of ILC3s. The relative mRNA expression level of IL-17A was also upregulated in overweight compared to nonoverweight children, as was the relative mRNA level of IL-22. However, there were no correlations between ILC3 frequencies or the expressions of RORC, IL-17A, and IL-22 and asthma severity. These results suggested that childhood obesity is an independent factor that is associated with an elevated frequency of circulating ILC3s and higher expressions of RORC, IL-22, and IL-17A.
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Affiliation(s)
- Yumin Wu
- Department of Laboratory Medicine, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Jiawei Yue
- Department of Orthopaedics, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Juncheng Wu
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Wei Zhou
- Department of Laboratory Medicine, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Dapeng Li
- Department of Orthopaedics, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu Province 212001, China
| | - Kai Ding
- Department of Orthopaedics, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Prince Amoah Barnie
- Department of Biomedical Science, School of Allied Health Sciences, University of Cape Coast, Ghana
| | - Xu Xu
- Department of Orthopaedics, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Huaxi Xu
- Department of Immunology, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu Province 212013, China
| | - Weifeng Shi
- Department of Laboratory Medicine, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
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12
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Han CH, Chung JH. Asthma and other allergic diseases in relation to suicidal behavior among South Korean adolescents. J Psychosom Res 2018; 115:94-100. [PMID: 30470324 DOI: 10.1016/j.jpsychores.2018.10.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/26/2018] [Accepted: 10/26/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Adolescent asthma can be the cause of social and psychological problems. We investigated the association between asthma with other allergic diseases and suicidal risk behavior among South Korean adolescents using nationally representative data. METHODS Web-based self-report data from the Korean Youth Risk Behavior Web-Based Survey were used in this study (N = 237,022). Complex sample logistic regression was used to define the relationship between suicidal behavior and asthma (n = 7177), with other allergic diseases [asthma with allergic rhinitis (AR) or asthma with atopic dermatitis (AD) (n = 9720), asthma with AD and AR (n = 4971)]. RESULTS Participants with asthma and other allergies showed a higher prevalence of substance use, greater sexual experience, greater perceived stress, poorer perceived health, more severe depression, more suicidal ideation, and more suicide attempts than those without allergy. Depression, suicidal ideation, and suicide attempts increased trend in the following order: no asthma, asthma only, asthma with one other allergy (asthma with AD or asthma with AR), and asthma with AD and AR. After adjusting for multiple confounders, the odds ratio for suicidal ideation with asthma and AD and AR was 1.13 [95% confidence interval (CI), 1.06-1.19] and that for suicide attempts was 1.31 (95% CI, 1.20-1.43). CONCLUSIONS Adolescent asthma and other allergies were associated with suicidal behavior.
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Affiliation(s)
- Chang Hoon Han
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Jae Ho Chung
- Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea.
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13
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Perla A V. The link between allergic disease and depression in young adults: A structural equation modelling analysis. ACTA ACUST UNITED AC 2018. [DOI: 10.17352/2455-5460.000033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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14
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Muhammad LN, Korte JE, Bowman CM, De Santis ML, Nietert PJ. The Effects of Asthma and Bullying on Suicidal Behaviors Among US Adolescents. THE JOURNAL OF SCHOOL HEALTH 2018; 88:762-767. [PMID: 30203476 PMCID: PMC6134875 DOI: 10.1111/josh.12680] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 11/29/2017] [Accepted: 12/14/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND Positive associations between suicidal behaviors and asthma have been established in previous adolescent studies. Few studies consider social risk factors, such as bullying. This study involved an analysis of suicidal behaviors and asthma, but also includes an assessment of whether these relationships were modified by the co-occurrence of bullying. METHODS Data included 13,154 participants from the 2013 Youth Risk Behavior Survey (YRBS), collected by the US Centers for Disease Control and Prevention. Logistic regression models were constructed and summarized using odds ratios (ORs) and 95% confidence intervals (95% CIs). RESULTS When comparing adolescents with asthma who were bullied at school to those who were not bullied at school, the odds of contemplating suicide were increased by nearly 2-fold (OR = 1.8, 95% CI = 1.5-2.3), and the odds of creating a suicide plan were 2.3 times higher (OR = 2.3, 95% CI = 1.7-3.1). The odds of a suicide attempt and incurring an injury from a suicide attempt were also substantially increased. Similarly, increased odds of suicidal behaviors were observed for adolescents with asthma who were bullied electronically. CONCLUSION Having asthma and being bullied are both associated with increased odds of suicidal behaviors.
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Affiliation(s)
- Lutfiyya N Muhammad
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite 303, Charleston, SC 29425-8350
| | - Jeffrey E Korte
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC 29425-8350
| | - Charles M Bowman
- Pediatrics-Pulmonology, Allergy and Immunology, Medical University of South Carolina, P.O. Box 250561, Charleston, SC 29425
| | - Mark L De Santis
- Department of Psychiatry and Behavioral Sciences, Ralph H. Johnson VA Medical Center, Medical University of South Carolina, 109 Bee Street, Charleston, SC 29401
| | - Paul J Nietert
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC 29425-8350
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15
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Sharma N, Akkoyunlu M, Rabin RL. Macrophages-common culprit in obesity and asthma. Allergy 2018; 73:1196-1205. [PMID: 29178573 DOI: 10.1111/all.13369] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2017] [Indexed: 12/29/2022]
Abstract
Macrophages are essential innate immune cells that also regulate local metabolism. Endogenous or exogenous stimuli may polarize macrophages toward phenotypes that serve distinct innate immunological metabolic functions. IFN-γ or lipopolysaccharide (LPS) polarizes macrophages toward the M1, or "classically activated" phenotype that participates in defense against intracellular pathogens. IL-4, IL-13, or chitin polarizes macrophages toward the M2, or "alternatively activated" phenotype, which defends against multicellular nematodes and fungi. As macrophages polarize in local environments, M1 and M2 macrophages may coexist in different organs and may differentially affect asthma and obesity, two comorbid diseases where polarized macrophages contribute to their pathogenesis. While M1 macrophages are considered beneficial in asthma and contribute to the pathology of obesity, M2 macrophages contribute to the pathology of asthma, but limit metabolic syndrome associated with obesity. Here, we discuss the roles for M1 and M2 macrophages in asthma and obesity, and propose a model by which M1-mediated inflammation in adipose tissue enhances M2-mediated inflammation in the asthmatic lung.
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Affiliation(s)
- N. Sharma
- Division of Bacterial, Parasitic and Allergenic Products Center for Biologics Evaluation and Research Office of Vaccines Research and Review U.S. Food and Drug Administration Silver Spring MD USA
| | - M. Akkoyunlu
- Division of Bacterial, Parasitic and Allergenic Products Center for Biologics Evaluation and Research Office of Vaccines Research and Review U.S. Food and Drug Administration Silver Spring MD USA
| | - R. L. Rabin
- Division of Bacterial, Parasitic and Allergenic Products Center for Biologics Evaluation and Research Office of Vaccines Research and Review U.S. Food and Drug Administration Silver Spring MD USA
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16
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Ferro MA, Rhodes AE, Kimber M, Duncan L, Boyle MH, Georgiades K, Gonzalez A, MacMillan HL. Suicidal Behaviour Among Adolescents and Young Adults with Self-Reported Chronic Illness. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2017; 62:845-853. [PMID: 28814100 PMCID: PMC5714119 DOI: 10.1177/0706743717727242] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aims of this study were to estimate the: (1) 12-mo prevalence of suicidal thoughts, plans, and attempts in a population sample of adolescents and young adults with and without chronic illness; (2) associations among chronic illness and suicidal thoughts and behaviour (STB); and, (3) moderating roles of mood and substance use disorder on this association. METHOD Individuals were aged 15 to 30 y ( n = 5,248) from the Canadian Community Health Survey-Mental Health. Twelve-month STB and psychiatric disorder were measured using the World Health Organization Composite International Diagnostic Interview 3.0. Multinomial logistic regression examined associations between chronic illness and STB, adjusting for relevant sociodemographic and health characteristics. Product term interactions among chronic illness, mood, and substance use disorders were included in the regression models to examine potential moderating effects. RESULTS Prevalence of suicidal thoughts, plans, and attempts was higher in individuals with chronic illness ( P < 0.01 for all). After adjustment, chronic illness increased the odds for suicidal thoughts [OR = 1.28 (1.01 to 1.64)], plans [OR = 2.34 (1.22 to 4.39)], and attempts [OR = 4.63 (1.52 to 14.34)]. In the presence v. absence of a mood disorder, the odds for suicidal thoughts were higher among individuals with chronic illness [OR = 1.89 (1.06 to 5.28)]. CONCLUSIONS Suicidal thoughts and behaviours are common among adolescents and young adults with chronic illness, particularly among those with comorbid mood disorders. Health professionals should routinely ask about STB during assessments of their adolescent and young adult patients.
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Affiliation(s)
- Mark A Ferro
- 1 School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario
| | - Anne E Rhodes
- 2 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario.,3 Department of Psychiatry, University of Toronto, Toronto, Ontario.,4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Melissa Kimber
- 4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Laura Duncan
- 4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Michael H Boyle
- 4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Katholiki Georgiades
- 4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Andrea Gonzalez
- 4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Harriet L MacMillan
- 4 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario.,5 Department of Pediatrics, McMaster University, Hamilton, Ontario
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17
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Chang HY, Seo JH, Kwon JW, Suh DI, Cho HJ, Yoon J, Kim EJ, Lee JS, Shin YJ, Hong SJ. Independent association among suicidal ideation, asthma, and bronchial hyperresponsiveness in adolescents. Clin Exp Allergy 2017; 47:1671-1674. [PMID: 28985451 DOI: 10.1111/cea.13041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- H Y Chang
- Department of Psychiatry and Behavioral Sciences, Ajou University School of Medicine, Suwon, Korea.,Sunflower Center of Southern Gyeonggi for Women and Children Victims of Violence, Suwon, Korea
| | - J-H Seo
- Department of Pediatrics, Dangook University Hospital, Cheonan, Korea
| | - J-W Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - D I Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - H-J Cho
- Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J Yoon
- Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - E-J Kim
- Division of Allergy and Chronic Respiratory Diseases, Center for Biomedical Sciences, Korean National Institute of Health, Korea Center for Diseases Control and Prevention, Osong, Korea
| | - J-S Lee
- Korean National Institute of Health, Korea Center for Diseases Control and Prevention, Osong, Korea
| | - Y-J Shin
- Department of Psychiatry and Behavioral Sciences, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - S-J Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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