Latimer: Finding a link of asthma to suicide
The association may sound like a stretch—but did you know that asthma and suicide seem to be linked somehow?
Research has shown that children with asthma have a much higher mortality rate than their peers. In addition, they have a greater than two-fold increase in completed suicide than the general population.
Several studies have found an association between asthma and suicide, but the largest was a study of more than 160,000 high school students in Taiwan who were followed up in young adulthood.
Although other studies have found an association between suicide attempts and asthma, this is the first study to link asthma with completed suicide in young people.
Certainly, this correlation is concerning—asthma rates have been on the rise for the past 20 years and experts estimate the rates worldwide are rising roughly 50 per cent per decade.
Today in Canada there are more than three million people with asthma—it affects roughly 12 per cent of children in our country.
In Canada, roughly 20 children and 500 adults die as a result of asthma each year.
But why should asthma sufferers also be at increased risk for suicide?
This is not yet fully understood, but there are several theories about why asthma, as well as comorbid anxiety and depression, may increase the risk of subsequent suicide.
One theory says asthma could interfere with normal development in youths by making it difficult to participate in social and physical activities.
Asthma could also have a negative impact on self esteem and lead to over protective parenting because of the child’s vulnerability to asthmatic episodes—causing conflict during adolescent years.
There is also a high prevalence of psychiatric conditions in people with asthma—one study found the prevalence of depression and anxiety disorders is twice as high in youths with asthma as those without—after controlling for socioeconomic status, other medical conditions and risky behaviours.
It seems that early development of respiratory symptoms is associated with a greater risk of depression and anxiety and early development of psychiatric disorders is also associated with a greater subsequent risk of asthma. Another theory gives a cognitive and biological explanation for the correlation between suicide and asthma, essentially the experience of asthma teaches fear of symptoms and scary health situations.
Repetitive experiences may sensitize the brain’s fear response and lead to depression or anxiety.
Whatever the reason, it is clear there is a marked increase in risk for psychiatric problems among those who experience asthma and parents and physicians monitoring the health of children and adolescents with asthma should be aware of the early symptoms and warning signs for anxiety and depression so they can offer help if it becomes necessary.
Paul Latimer is a psychiatrist and president of Okanagan Clinical Trials.