Newswise — Asthma is associated with higher suicidal thoughts with attempted suicide, but does not seem to be linked with suicidal thoughts without attempts, according to a report published this month in Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI).

Cigarette smoking and concurrent mental health conditions may independently account for significant proportions (but not all) of the association between asthma and suicidal thoughts with attempts noted Diana E. Clarke, MSc, PhD, The Johns Hopkins University School of Public Health, Baltimore, and colleagues.

There is growing evidence of relationships between respiratory diseases and suicidal behaviors, but investigators say this is the first study to examine the association between asthma and suicidal thinking with and without attempts using a nationally representative sample of adults. They also note it is the first study to investigate the potential role of cigarette use and nicotine dependence in the association of asthma and suicidal behavior.

The study examined data on 5,692 individuals 18 years and older from the US National Comorbidity Survey Replication. Approximately 12 percent of the sample had a history of asthma. The estimates of lifetime prevalence for suicidal ideation without and with attempts and asthma were 8.7 percent, 4.2 percent and 12.0 percent, respectively, and occurred more frequently in women that men. Despite adjustments for cigarette smoking, concurrent mental health conditions and common sociodemographic factors, a statistically significant association remained between asthma and suicide thoughts and attempts.

Investigators suggest that asthma may be associated with the more severe form of suicidal behavior, but not the milder forms of suicidal thoughts without attempts.

"Researchers have speculated that the relationship between asthma and suicidal behaviors is possibly because of ensuing mood and anxiety that results from disability and discomfort associated with asthma, which can be a lifelong disease," they note. "Individuals might have frequent thoughts of death with increasing severity solely because they have a potentially life-threatening illness."

Although this was not a clinical study, the findings may indicate the need for referral to mental services if an individual has asthma and expresses suicidal thoughts.

Patient information on allergic diseases, including asthma, is available by calling the ACAAI toll free number at (800) 842-7777 or visiting its Web site at http://www.acaai.org.

An allergist-immunologist is a physician who specializes in the diagnosis and treatment of asthma and other allergic diseases. The allergist is specially trained to identify the allergic and non-allergic factors that trigger asthma and other allergic diseases. Allergists help people treat or prevent their allergy problems. After earning a medical degree, the allergist-immunologist completes a three-year residency training program in either internal medicine or pediatrics. Next the allergist completes two or three more years of study in the field of allergy-immunology in order to prepare for certification by the American Board of Allergy and Immunology.

The American College of Allergy, Asthma and Immunology (ACAAI) is a professional medical organization headquartered in Arlington Heights, Ill., that promotes excellence in the practice of the subspecialty of allergy and immunology. The College, comprising more than 5,000 allergists-immunologists and related health care professionals, fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy and research.

Citation: Clarke DE, Goodwin RD, Messias E, Eaton WW. Asthma and suicidal ideation with and without suicide attempts among adults in the United States: What is the role of cigarette smoking and mental disorders? Ann Allergy Asthma Immunol 2008;100:439-446.

Annals of Allergy, Asthma & Immunology is online at http://www.annallergy.org.

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Annals of Allergy, Asthma & Immunology