The frequency of suicidal ideation in asthma and the relationship to asthma control and depression

Abstract

Background: There is considerable evidence from clinical and epidemiological studies linking asthma to an increased risk of suicide.

Objective: To provide preliminary data among Nigerians on the frequency and characteristics of suicidal ideation in asthma.

Methods: A cross-sectional study among consecutively consenting asthma patients attending the respiratory clinic of the Lagos University Teaching Hospital in Lagos, Nigeria, over a six month period. Level of asthma control was assessed using the Asthma Control Test (ACT). The Beck Scale for Suicidal Ideation (BSI) and the Suicide items of Beck's Depressive Inventory (BDI) were used to obtain data on suicidal ideation and the risk of depression respectively. Correlation and regression analysis were performed.

Results: Eighty one (66.7% women) adult asthma patients participated. Their mean age was 46.3±13.0 years, mean ACT score was 18.7±4.3 (maximum score 25) and mean BDI score was 3.6 ± 4.0 (maximum score 63). There was a significant negative relationship between the ACT score and the BDI score (p<0.001). The mean BSI score was 3.0±2.2. The frequency of suicidal ideation was 7.4% (BSI score >1). The mean BDI score was significantly higher among participants with suicidal ideation compared to those without suicidal ideation (6.8±5.2 versus 3.4±3.8, p=0.04). Among the participants with suicidal ideation, the BDI score and ACT score were negatively and insignificantly correlated to the BSI score (Pearson's correlation= -0.26, p=0.62), (Pearson's correlation=-0.03, p=0.96) respectively.

Conclusion: The frequency of suicidal ideation among patients with asthma is modest. Participants with suicidal ideation were more symptomatic for depression and most had poor asthma control. This highlights the need for increased recognition and treatment of co-morbid psychiatric illness among asthma patients.

Keywords: Asthma, suicide, Nigeria, comorbidity, depressio