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Chen VCH, Wang TN, Kuo CJ, Yang YH, Lee CP, Stewart R, Wu SI. Associations of asthma and psychiatric comorbidities on suicide mortality among community adolescents: A 20-year cohort study. Psychiatry Res 2024; 340:116087. [PMID: 39182318 DOI: 10.1016/j.psychres.2024.116087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 07/01/2024] [Accepted: 07/14/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND The role of psychiatric comorbidity as a confounder between asthma and subsequent suicide mortality in adolescents remained unclarified. METHODS This study used a 20-year community-based cohort in Taiwan. Adolescents aged 11 to 16 from 123 schools were classified into three subgroups: current asthma (symptoms present in the past year), previous asthma (history of asthma but no symptoms in the past year), and no asthma. The mortality and medical care utilizations until the end of follow-up in 2015 were obtained. Cox proportional hazard and competing risk models were performed. Different adjustment models that included covariates of demographic status, allergy, cigarette smoking, psychiatric diagnoses, alcohol or substance misuse, and attention deficit and hyperactivity disorders were compared. RESULTS During the follow-up, 285 out of 153,526 participants died from suicide. The crude hazard ratio for suicide was 1.95 (95 % CI=1.46∼2.60) in the current asthma subgroup and 2.01 (1.36∼2.97) in the previous asthma subgroup. The adjusted hazard ratios (aHR) attenuated to 1.67 (1.25∼2.24) and 1.72 (1.16∼2.54) respectively after further adjustment for all mental disorders, ADHD, substance, and alcohol use disorders. CONCLUSIONS Our adjustment analyses stratified by different models highlight evidence of asthma as an independent risk factor that predicts suicide among adolescents. Depression and mental disorders were potential confounders and identifications of asthma and psychiatric disorders might help decrease suicide risk.
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Affiliation(s)
- Vincent Chin-Hung Chen
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Tsu-Nai Wang
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Yao-Hsu Yang
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Center of Excellence for Chang-Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chuan-Pin Lee
- Center of Excellence for Chang-Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Robert Stewart
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Shu-I Wu
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Section of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan.
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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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Abstract
Mutations in the genes coding for tryptophan-hydrolase-2 and the scaffold protein FKBP5 are associated with an increased risk of suicide. The mutation in both cases enhances the enzymatic activity of glycogen synthase kinase-3 (GSK3). Conversely, anti-suicidal medications, such as lithium, clozapine, and ketamine, indirectly inhibit the activity of GSK3. When GSK3 is active, it promotes the metabolic removal of the transcription factor NRF2 (nuclear factor erythroid 2-related factor-2), which suppresses the transcription of multiple genes that encode anti-oxidative and anti-inflammatory proteins. Notably, several suicide-biomarkers bear witness to an ongoing inflammatory process. Moreover, alterations in serum lipid levels measured in suicidal individuals are mirrored by data obtained in mice with genetic deletion of the NRF2 gene. Inflammation is presumably causally related to both dysphoria and anger, two factors relevant for suicide ideation and attempt. Preventing the catabolism of NRF2 could be a strategy to obtain novel suicide-prophylactic medications. Possible candidates are minocycline and nicotinic-α7 agonists. The antibiotic minocycline indirectly activates NRF2-transcriptional activity, whereas the activation of nicotinic-α7 receptors indirectly inhibits GSK3.
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Kim JY, Han YJ, Lee JS, Lee JH, Jo SH, Kim SH. Evaluation of a possible association between allergic rhinitis and depression, suicidal ideation, and suicide attempts among adolescents based on a nationwide cross-sectional study. Int J Pediatr Otorhinolaryngol 2020; 134:110070. [PMID: 32387708 DOI: 10.1016/j.ijporl.2020.110070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/23/2020] [Accepted: 04/23/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE We assessed associated factors for depression and suicidality among adolescents with allergic rhinitis (AR) by analyzing data from annual Korea Youth Risk Behavior Web-based Surveys (KYRBSs) completed from 2007 to 2017. METHODS Data from the KYRBS were obtained from a stratified, multistage, clustered sample. Using self-reported questionnaires, students provided yes-or-no answers to questions addressing their doctor-diagnosed AR and self-experienced depression, suicidal ideation and suicide attempts. Associated factors for depression and suicidality were identified by logistic regression models after controlling for potential confounding factors. A total of 818,684 adolescents were targeted, and 788,411 adolescents completed the survey. RESULTS An AR diagnosis was reported in 30.8% of respondents. Among respondents with AR, 34.5%, 18.4%, and 4.2% reported depression, suicidal ideation, and suicide attempts, respectively. Adolescents with AR were significantly more likely to have negative mental health status, including suicidality than adolescents without AR. After multiple logistic regression analyses, perception of stress was most strongly associated with depression and suicidal ideation (adjusted odds ratio: 5.16 [95% confidence interval; 5.04-5.28], 4.81 [4.65-4.98], respectively). For suicide attempts, subjective unhappiness was most strongly associated (3.63 [3.47-3.79]) among adolescents with AR. Presence of AR itself was also associated with depression and suicidality (1.10 [1.08-1.11], 1.08 [1.06-1.10], 1.05 [1.01-1.08], respectively). CONCLUSION Adolescents with AR had significantly greater prevalence of depression and suicidality. Multidisciplinary team approaches, including psychological support, may be needed to prevent suicide among adolescents with AR, especially those with identifiable risk factors.
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Affiliation(s)
- Joo Young Kim
- 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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Scadding GK, Kariyawasam HH, Scadding G, Mirakian R, Buckley RJ, Dixon T, Durham SR, Farooque S, Jones N, Leech S, Nasser SM, Powell R, Roberts G, Rotiroti G, Simpson A, Smith H, Clark AT. BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (Revised Edition 2017; First edition 2007). Clin Exp Allergy 2019; 47:856-889. [PMID: 30239057 DOI: 10.1111/cea.12953] [Citation(s) in RCA: 135] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/01/2017] [Accepted: 05/04/2017] [Indexed: 12/12/2022]
Abstract
This is an updated guideline for the diagnosis and management of allergic and non-allergic rhinitis, first published in 2007. It was produced by the Standards of Care Committee of the British Society of Allergy and Clinical Immunology, using accredited methods. Allergic rhinitis is common and affects 10-15% of children and 26% of adults in the UK, it affects quality of life, school and work attendance, and is a risk factor for development of asthma. Allergic rhinitis is diagnosed by history and examination, supported by specific allergy tests. Topical nasal corticosteroids are the treatment of choice for moderate to severe disease. Combination therapy with intranasal corticosteroid plus intranasal antihistamine is more effective than either alone and provides second line treatment for those with rhinitis poorly controlled on monotherapy. Immunotherapy is highly effective when the specific allergen is the responsible driver for the symptoms. Treatment of rhinitis is associated with benefits for asthma. Non-allergic rhinitis also is a risk factor for the development of asthma and may be eosinophilic and steroid-responsive or neurogenic and non- inflammatory. Non-allergic rhinitis may be a presenting complaint for systemic disorders such as granulomatous or eosinophilic polyangiitis, and sarcoidoisis. Infective rhinitis can be caused by viruses, and less commonly by bacteria, fungi and protozoa.
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Affiliation(s)
- G K Scadding
- The Royal National Throat Nose and Ear Hospital, London, UK
| | - H H Kariyawasam
- The Royal National Throat Nose and Ear Hospital, London, UK.,UCLH NHS Foundation Trust, London, UK
| | - G Scadding
- Department of Upper Respiratory Medicine, Imperial College NHLI, London, UK
| | - R Mirakian
- The Royal National Throat Nose and Ear Hospital, London, UK
| | - R J Buckley
- Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
| | - T Dixon
- Royal Liverpool and Broad green University Hospital NHS Trust, Liverpool, UK
| | - S R Durham
- Department of Upper Respiratory Medicine, Imperial College NHLI, London, UK
| | - S Farooque
- Chest and Allergy Department, St Mary's Hospital, Imperial College NHS Trust, London, UK
| | - N Jones
- The Park Hospital, Nottingham, UK
| | - S Leech
- Department of Child Health, King's College Hospital, London, UK
| | - S M Nasser
- Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
| | - R Powell
- Department of Clinical Immunology and Allergy, Nottingham University, Nottingham UK
| | - G Roberts
- Department of Child Health, University of Southampton Hospital, Southampton, UK
| | - G Rotiroti
- The Royal National Throat Nose and Ear Hospital, London, UK
| | - A Simpson
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, UK
| | - H Smith
- Division of Primary Care and Public Health, University of Sussex, Brighton, UK
| | - A T Clark
- Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
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Bergmans RS, Kelly KM, Mezuk B. Inflammation as a unique marker of suicide ideation distinct from depression syndrome among U.S. adults. J Affect Disord 2019; 245:1052-1060. [PMID: 30699847 PMCID: PMC6448785 DOI: 10.1016/j.jad.2018.11.046] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/19/2018] [Accepted: 11/03/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Recent evidence suggests that pro-inflammatory states may be independently associated with the risk of suicidality, above and beyond depression. This study assesses whether four indicators of inflammation, circulating levels of C-reactive protein (CRP), white blood cell (WBC) count and immunoglobulin E (IgE), and dietary inflammatory potential, measured using the Dietary Inflammatory Index® (DII), distinguish suicidal ideation (SI) from major depression (MD). METHODS Data come from multiple cycles of the US National Health and Nutrition Examination Survey (NCRP&WBC = 13,912; NDII = 17,076; NIgE = 4,060). MD was measured using the Patient Health Questionnaire-9 (PHQ-9); SI was indicated by the last item of the PHQ-9. To assess SI independent from MD, participants were classified into four categories: SI with MD, SI without MD, MD without SI, and neither MD nor SI. Regression models were used to assess the relationship between indicators of inflammation and SI with and without MD. RESULTS None of the inflammatory indicators were able to distinguish SI status among MD cases. DII was associated with SI among individuals without MD. CRP, DII, and WBC were associated with MD. No associations were found for IgE. LIMITATIONS Cross-section data prevent drawing causal conclusions. Underreporting of MD and suicidal ideation and measurement of habitual diet using 24 h dietary recalls are also weaknesses. CONCLUSION Dietary inflammatory potential was associated with suicide ideation among US adults with and without depression. Diet may play a role in suicide ideation and more empirical evidence is needed to determine whether nutritional protocols could aid in the treatment of suicidal behaviors. Findings did not support inflammatory factors having a relationship with suicide ideation distinct from depression.
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Affiliation(s)
- Rachel S Bergmans
- UM SPH Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Kristen M Kelly
- UM SPH Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Briana Mezuk
- UM SPH Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
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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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Bedolla-Barajas M, Pulido-Guillén NA, Vivar-Aburto B, Morales-Romero J, Ortiz-Peregrina JR, Robles-Figueroa M. Is suicidal ideation associated with allergic asthma and allergic rhinitis? ACTA ACUST UNITED AC 2019. [PMID: 29538540 PMCID: PMC6130331 DOI: 10.1590/s1806-37562017000000129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective: To investigate whether there is an association between suicidal ideation (SI) and allergic diseases in adults. Methods: This was a comparative cross-sectional study involving individuals ranging from 20 to 50 years of age recruited from a university hospital in the city of Guadalajara, Mexico. We included patients with a confirmed diagnosis of allergic asthma, those with a confirmed diagnosis of allergic rhinitis, and healthy controls. All subjects completed the Beck Depression Inventory-II (BDI-II), which includes an item that evaluates the presence of suicidal thoughts or desires within the last two weeks, in order to identify SI. Results: The sample comprised 115 patients with allergic asthma, 111 patients with allergic rhinitis, and 96 healthy controls. The number of individuals identified with SI in the three groups were, respectively, 17 (14.8%), 13 (11.7%), and 8 (8.3%). Regarding the presence of SI, no statistically significant association was found in the allergic asthma group (OR = 1.98; 95% CI: 0.78-4.64; p = 0.154) or in the allergic rhinitis group (OR = 1.46; 95% CI: 0.58-3.68; p = 0.424) when they were compared with the control group. However, the presence of depression was associated with SI in the three groups: allergic asthma (OR = 12.36; 95% CI: 2.67-57.15; p = 0.001); allergic rhinitis (OR = 6.20; 95% CI: 1.66-23.14; p = 0.006); and control (OR = 21.0; 95% CI: 3.75-117.36; p < 0,001). Conclusions: In comparison with the control group, no association was found between SI and the groups with allergic diseases. In contrast, there was association between SI and depression in the three groups.
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Affiliation(s)
- Martín Bedolla-Barajas
- . Servicio de Alergia e Inmunología Clínica, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, México
| | | | - Bolívar Vivar-Aburto
- . Servicio de Medicina Interna, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, México
| | | | - José Raúl Ortiz-Peregrina
- . Departamento de Inhaloterapia, Neumología y Alergia, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, México
| | - Martín Robles-Figueroa
- . Servicio de Medicina Interna, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, México
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Oh H, Koyanagi A, DeVylder JE, Stickley A. Seasonal Allergies and Psychiatric Disorders in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091965. [PMID: 30205581 PMCID: PMC6164754 DOI: 10.3390/ijerph15091965] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/06/2018] [Accepted: 09/06/2018] [Indexed: 12/22/2022]
Abstract
Seasonal allergies have been associated with mental health problems, though the evidence is still emergent, particularly in the United States. We analyzed data from the National Comorbidity Survey Replication and the National Latino and Asian American Survey (years 2001–2003). Multivariable logistic regression models were used to examine the relations between lifetime allergies and lifetime psychiatric disorders (each disorder in a separate model), adjusting for socio-demographic variables (including region of residence) and tobacco use. Analyses were also stratified to test for effect modification by race and sex. A history of seasonal allergies was associated with greater odds of mood disorders, anxiety disorders, and eating disorders, but not alcohol or substance use disorders, after adjusting for socio-demographic characteristics and tobacco use. The associations between seasonal allergies and mood disorders, substance use disorders, and alcohol use disorders were particularly strong for Latino Americans. The association between seasonal allergies and eating disorders was stronger for men than women. Seasonal allergies are a risk factor for psychiatric disorders. Individuals complaining of seasonal allergies should be screened for early signs of mental health problems and referred to specialized services accordingly.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34 th St., Los Angeles, CA 90089-0411, USA.
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Deu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain.
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, 28029 Madrid, Spain.
| | - Jordan E DeVylder
- Graduate School of Social Service, Fordham University, 113 W 60th Street, New York, NY 10023, USA.
| | - Andrew Stickley
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, 141 89 Huddinge, Sweden.
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo 1878553, Japan.
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Stickley A, Sheng Ng CF, Konishi S, Koyanagi A, Watanabe C. Airborne pollen and suicide mortality in Tokyo, 2001-2011. ENVIRONMENTAL RESEARCH 2017; 155:134-140. [PMID: 28219016 DOI: 10.1016/j.envres.2017.02.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/25/2017] [Accepted: 02/09/2017] [Indexed: 06/06/2023]
Abstract
Prior research has indicated that pollen might be linked to suicide mortality although the few studies that have been undertaken to date have produced conflicting findings and been limited to Western settings. This study examined the association between the level of airborne pollen and suicide mortality in Tokyo, Japan in the period from 2001 to 2011. The daily number of suicide deaths was obtained from the Japanese Ministry of Health, Labour and Welfare, with pollen data being obtained from the Tokyo Metropolitan Institute of Public Health. A time-stratified case-crossover study was performed to examine the association between different levels of pollen concentration and suicide mortality. During the study period there were 5185 male and 2332 female suicides in the pollen season (February to April). For men there was no association between airborne pollen and suicide mortality. For women, compared to when there was no airborne pollen, the same-day (lag 0) pollen level of 30 to <100 grains per cm2 was associated with an approximately 50% increase in the odds for suicide (e.g. 30 to <50 grains per cm2: odds ratio 1.574, 95% confidence interval 1.076-2.303, p=0.020). The estimates remained fairly stable after adjusting for air pollutants and after varying the cut-points that defined the pollen levels. Our results indicate that pollen is associated with female suicide mortality in Tokyo.
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Affiliation(s)
- Andrew Stickley
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden.
| | - Chris Fook Sheng Ng
- Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Shoko Konishi
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Anthropology, University of Washington, Box 353100, Seattle, WA 98195, USA
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas,, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| | - Chiho Watanabe
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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11
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Mental Health in Allergic Rhinitis: Depression and Suicidal Behavior. CURRENT TREATMENT OPTIONS IN ALLERGY 2017; 4:71-97. [PMID: 28966902 DOI: 10.1007/s40521-017-0110-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
A high proportion of suicides visit their medical provider in the month prior to death, but depression, suicidal thoughts, and substance use are seldom addressed. For the clinicians routinely treating a substantial patient population with allergic diseases, there are additional concerns, as allergy has been linked with both depression and suicidal behavior. While psychotropic medications may affect diagnosis of allergies, medications used to treat allergies impact mood and behavior. Thus, we present an overview of the overlap of allergic rhinitis with depression and suicidal behavior in adults, based on clinical and epidemiological data, and our research and clinical experience. In summary, we suggest: 1) inquiring among patients with allergies about personal and family history of depression, substance use disorders, suicidal ideation and attempts 2) increased mindfulness regarding the potential effects of allergy medications on mood and behavior; and 3) for people identified with certain types of depression or increased suicide risk, a systematic multilevel collaborative approach. While for practical reasons the majority of patients with depression will continue to be treated by general or family practitioners, the allergy-treating provider should always consider integrated care for bipolar, psychotic or suicidal depression and incomplete remission, or relapsing and highly recurrent course. While awaiting results of much needed basic and clinical research to guide clinical approach for patients with comorbid allergic rhinitis and depression, the simple steps recommended here are expected to improved clinical outcomes in depression, including, on a large scale, reduced premature deaths by suicide.
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12
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Xi L, Cao F, Zhang Y, Zhang L. Severity of nasal obstruction can predict the anxiety status of patients with allergic rhinitis but not patients with vasomotor rhinitis. Int Forum Allergy Rhinol 2016; 6:1196-1203. [PMID: 27277070 DOI: 10.1002/alr.21802] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 04/21/2016] [Accepted: 04/26/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Lin Xi
- Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital; Capital Medical University; Beijing China
- Beijing Key Laboratory of Nasal Diseases; Beijing Institute of Otolaryngology; Beijing China
- Institute of Psychology; Chinese Academy of Sciences; Beijing China
- Department of Allergy, Beijing TongRen Hospital; Capital Medical University; Beijing China
| | - Feifei Cao
- Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital; Capital Medical University; Beijing China
- Beijing Key Laboratory of Nasal Diseases; Beijing Institute of Otolaryngology; Beijing China
- Department of Allergy, Beijing TongRen Hospital; Capital Medical University; Beijing China
| | - Yuan Zhang
- Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital; Capital Medical University; Beijing China
- Beijing Key Laboratory of Nasal Diseases; Beijing Institute of Otolaryngology; Beijing China
- Department of Allergy, Beijing TongRen Hospital; Capital Medical University; Beijing China
| | - Luo Zhang
- Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital; Capital Medical University; Beijing China
- Beijing Key Laboratory of Nasal Diseases; Beijing Institute of Otolaryngology; Beijing China
- Department of Allergy, Beijing TongRen Hospital; Capital Medical University; Beijing China
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13
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Lee D, Seo JY, Lee CS, Park CS, Kim BJ, Cha B, Lee SJ. Allergic diseases, excessive Internet use and suicidal ideation in Korean adolescents. Compr Psychiatry 2015; 62:100-4. [PMID: 26343473 DOI: 10.1016/j.comppsych.2015.06.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 06/01/2015] [Accepted: 06/17/2015] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The aim of this study is to evaluate the relation between suicidal ideation, allergic diseases, and excessive Internet use in Korean youth using a national representative dataset. METHODS Data from the Korean Youth Risk Behavior Web-Based Survey (KYRBWS), conducted by the Korean Centers for Disease Control and Prevention, were used in this study. Complex sample logistic regression and structural equation modeling were performed to define the relation between suicidal ideation, allergic disease and excessive Internet use. RESULTS A total of 73,238 students participated in this survey. In Korea, 19.3% of adolescents had suicidal ideation in the previous year. Asthma (OR=1.23, 95% CI=1.15-1.32, p<0.01) and allergic rhinitis (OR=1.17, 95% CI=1.11-1.22, p<0.01) were identified as risk factors for suicidal ideation after adjusting for school and family factors. Structural equation modeling showed that excessive Internet use interacted with the association between allergic diseases and suicidal ideation. CONCLUSION Allergy problems could positively affect suicidal ideation in Korean adolescents. Excessive Internet use could be a mediating factor between allergic disease and suicidal ideation.
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Affiliation(s)
- Dongyun Lee
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Ji-Yeong Seo
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Cheol-Soon Lee
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Korea.
| | - Chul-Soo Park
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Bong-Jo Kim
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Boseok Cha
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - So-Jin Lee
- Department of Psychiatry, Gyeongsang National University Hospital, School of Medicine, Gyeongsang National University, Jinju, Korea
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Crawford AA, Galobardes B, Jeffreys M, Davey Smith G, Gunnell D. Risk of suicide for individuals reporting asthma and atopy in young adulthood: findings from the Glasgow Alumni study. Psychiatry Res 2015; 225:364-7. [PMID: 25596956 PMCID: PMC4326175 DOI: 10.1016/j.psychres.2014.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 11/26/2014] [Accepted: 12/03/2014] [Indexed: 11/23/2022]
Abstract
There is emerging evidence that asthma and atopy may be associated with a higher risk of suicide. We investigated the association of asthma and atopy with mortality from suicide (n=32) in the Glasgow Alumni cohort, adjusting for the key confounders of socioeconomic position and smoking. We found no evidence of an association in our a priori atopy phenotypes with suicide, and there were insufficient suicides in the asthma phenotypes to draw any conclusions. In additional analyses, individuals reporting both eczema-urticaria and hay fever and those with family history of atopy were at higher risk of suicide. As these were secondary analyses and based on small numbers of events we cannot rule out chance findings. The lack of evidence in our main hypothesis may be due to the small number of suicides or reported associations between asthma and atopy may be confounded.
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Affiliation(s)
- Andrew A. Crawford
- School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK,Corresponding author. Tel.: +44 11733 10177; fax: +44 11733 14026.
| | - Bruna Galobardes
- School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK
| | - Mona Jeffreys
- School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 2BN, UK
| | - David Gunnell
- School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK
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Identifying rare variants for genetic risk through a combined pedigree and phenotype approach: application to suicide and asthma. Transl Psychiatry 2014; 4:e471. [PMID: 25335167 PMCID: PMC4350517 DOI: 10.1038/tp.2014.111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 08/28/2014] [Indexed: 12/13/2022] Open
Abstract
Suicidal behavior is a complex disorder, with evidence for genetic risk independent of other genetic risk factors including psychiatric disorders. Since 1996, over 3000 DNA samples from Utah suicide decedents have been collected and banked for research use through the Utah Medical Examiner. In addition, over 12,000 Utah suicides were identified through examination of death certificates back to 1904. By linking this data with the Utah Population Database, we have identified multiple extended pedigrees with increased risk for suicide completion. A number of medical conditions co-occur with suicide, including asthma, and this study was undertaken to identify genetic risk common to asthma and suicide. This study tests the hypothesis that a particular comorbid condition may identify a more homogeneous genetic subgroup, facilitating the identification of specific genetic risk factors in that group. From pedigrees at increased risk for suicide, we identified three pedigrees also at significantly increased familial risk for asthma. Five suicide decedents from each of these pedigrees, plus an additional three decedents not from these pedigrees with diagnosed asthma, and 10 decedents with close relatives with asthma were genotyped. Results were compared with 183 publicly available unaffected control exomes from 1000 Genomes and CEPH (Centre d'etude du polymorphisme humain) samples genotyped on the same platform. A further 432 suicide decedents were also genotyped as non-asthma suicide controls. Genotyping was done using the Infinium HumanExome BeadChip. For analysis, we used the pedigree extension of Variant Annotation, Analysis and Search Tool (pVAAST) to calculate the disease burden of each gene. The Phenotype Driven Variant Ontological Re-ranking tool (Phevor) then re-ranked our pVAAST results in context of the phenotype. Using asthma as a seed phenotype, Phevor traversed biomedical ontologies and identified genes with similar biological properties to those known to result in asthma. Our top associated genes included those related to neurodevelopment or neural signaling (brain-derived neurotrophic factor (BDNF), neutral sphingomyelinase 2 (SMPD2), homeobox b2 (HOXB2), neural cell adhesion molecule (NCAM2), heterogeneous nuclear ribonucleoprotein A0 (HNRNPA0)), inflammation (free fatty acid receptor 2 (FFAR2)) and inflammation with additional evidence of neuronal involvement (oxidized low density lipoprotein receptor 1 (OLR1), toll-like receptor 3 (TLR3)). Of particular interest, BDNF has been previously implicated in both psychiatric disorders and asthma. Our results demonstrate the utility of combining pedigree and co-occurring phenotypes to identify rare variants associated with suicide risk in conjunction with specific co-occurring conditions.
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Patusky KL, Caldwell B, Unkle D, Ruck B. Incorporating the treatment of medical and psychiatric disorders in the critical care area. Crit Care Nurs Clin North Am 2012; 24:53-80. [PMID: 22405712 DOI: 10.1016/j.ccell.2012.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Critical care areas are fast moving, often chaotic, and therefore confusing, even frightening, to patients attempting to understand what has happened to them. The nurse acts to mitigate these reactions by understanding the range of possibilities that can occur with patients, including potential psychiatric issues, and serving as patient advocate to ensure that appropriate treatment is initiated. Certainly there may be other psychiatric problems not described in the preceding text. The main possibilities are covered in this article. Assessing and acting early are tools the critical care nurse uses to meet patient needs and prevent behavioral problems that can interfere with life-preserving care.
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Affiliation(s)
- Kathleen L Patusky
- Graduate Programs, School of Nursing, University of Medicine & Dentistry of New Jersey, Newark, NJ 07101, USA.
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Christodoulou C, Douzenis A, Papadopoulos FC, Papadopoulou A, Bouras G, Gournellis R, Lykouras L. Suicide and seasonality. Acta Psychiatr Scand 2012; 125:127-46. [PMID: 21838741 DOI: 10.1111/j.1600-0447.2011.01750.x] [Citation(s) in RCA: 133] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Seasonal variation of deaths by suicide offers an important pathway in the study of possible suicide determinants of suicide and consequently suicide prevention. METHOD We conducted a review of the literature on suicide seasonality, assessing articles published between 1979 and 2009. RESULTS The majority of the studies confirm a peak in spring, mainly for men, older individuals, and violent methods of suicide. A secondary peak during autumn is observed. There is no common seasonality pattern for suicide methods. However, there are also certain studies that did not confirm seasonal variation. Inconsistent results with reduced, unchanged, and even increased suicide seasonality have been reported. Aspects on the association between seasonality and suicides are discussed. Except sex, age, and method of suicide, other parameters were taken into account to find more specific characteristics of seasonality in suicides as well. The influence of clinical, bioclimatic, sociodemographic as well as biological factors seems to affect the seasonal variation. CONCLUSION Studies from both the Northern and the Southern hemisphere report a seasonal pattern for suicides. These studies are not only an important source of epidemiological data for suicides but also represent a global effort to uncover hidden parameters of this self-destructive behaviour.
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Affiliation(s)
- C Christodoulou
- Second Department of Psychiatry, University of Athens Medical School, Attikon Hospital, Athens, Greece.
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Woo JM, Gibbons RD, Rogers CA, Qin P, Kim JB, Roberts DW, Noh ES, Mann JJ, Postolache TT. Pollen counts and suicide rates. Association not replicated. Acta Psychiatr Scand 2012; 125:168-75. [PMID: 22176539 PMCID: PMC6452436 DOI: 10.1111/j.1600-0447.2011.01813.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To replicate a previously reported association between pollen counts and county suicide rates in the continental United States, across space and time. METHOD The authors evaluated the relationship between airborne pollen counts and suicide rates in 42 counties of the continental United States, containing a pollen-counting station participating in the Aeroallergen Monitoring Network in the United States (N = 120,076 suicides), considering years' quarter, age group, sex, race, rural/urban location, number of local psychiatrists, and median household income, from 1999 to 2002. The county-level effects were broken into between-county and within-county. RESULTS No within-county effects were found. Between-county effects for grass and ragweed pollen on suicide rates lost statistical significance after adjustment for median income, number of psychiatrists, and urban vs. rural location. CONCLUSION Future research is necessary to reappraise the previously reported relationship between pollen levels and suicide rates that may have been driven by socioeconomic confounders.
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Affiliation(s)
- J. M. Woo
- Mood and Anxiety Program (MAP), Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA,Department of Psychiatry, Seoul Paik Hospital, Inje University School of Medicine,Stress Research Institute, Inje University, Seoul, Korea
| | - R. D. Gibbons
- Center for Health Statistics, University of Chicago, Chicago, IL
| | - C. A. Rogers
- Environmental Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - P. Qin
- National Centre for Register-Based Research, University of Aarhus, Aarhus C, Denmark
| | - J. B. Kim
- Center for Health Statistics, University of Chicago, Chicago, IL
| | | | - E. S. Noh
- Stress Research Institute, Inje University, Seoul, Korea
| | - J. J. Mann
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - T. T. Postolache
- Mood and Anxiety Program (MAP), Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA,National Center for the Treatment of Phobias, Anxiety and Depression, Washington, DC, USA
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Qin P, Mortensen PB, Waltoft BL, Postolache TT. Allergy is associated with suicide completion with a possible mediating role of mood disorder - a population-based study. Allergy 2011; 66:658-64. [PMID: 21143241 DOI: 10.1111/j.1398-9995.2010.02523.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND With increasing research suggesting a role of allergy on suicidality, this study, on a population level, delved into how allergy affects risk for suicide completion in the context of mood disorder and other factors. METHODS Based on the entire population of Denmark, we included 27,096 completed suicides and 467,571 live controls matched on sex and age with a nested case-control design. We retrieved personal information on hospital contacts for allergy and other variables from various Danish longitudinal registries and analyzed the data with conditional logistic regression. RESULTS We noted that 1.17% suicide victims, compared with 0.79% matched controls, had a history of hospital contact for allergy and that a history of allergy predicted an increased risk for suicide completion; however, the effect was confined to allergy that led to inpatient treatment (IRR: 1.59, 95% CI: 1.41-1.80). The increased risk was attenuated somewhat but remained significant when adjusted for personal psychiatric history and socioeconomic status. Meanwhile, we observed a nonsignificantly stronger effect in women than in men, and a significant age difference with a stronger effect for individuals at high ages. Moreover, we detected a significant interaction between allergy and mood disorder - even an antagonism effect of the two exposures. Allergy increased suicide risk only in persons with no history of mood disorder, whereas it eliminated suicide risk in those with a history of mood disorder. CONCLUSIONS The findings support a link between allergy and suicidality, with a possible mediating role of mood disorder.
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Affiliation(s)
- P Qin
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
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