Photo Credit: Afry Harvy

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: Our study has shown that, while there initially appeared to be a link between having asthma and living with suicidality, this association was no longer present after controlling for demographic factors and social determinants of health. It was shown that before propensity score matching, there was a statistical association between currently having asthma and having had recent suicidal thoughts and attempts. However, after controlling for a large number of demographic and health-related covariates, no statistical relationship persisted between asthma and suicidal thoughts, planning, or attempts.

The findings from our study differ from those of numerous past studies, which instead showed a potential association between having asthma and having some form of suicidality. Overall, these discrepancies across studies highlight the significance of using propensity score matching, as well as other statistical approaches such as penalized regression, and the Cochran-Mantel-Haenszel method, to better understand the relationship between asthma and suicidality. More research is needed to better understand the extent to which specific confounders influence this relationship. It is recommended that future research explores these factors to better understand the relationship between asthma and suicidality, as well as to better understand the social and lived realities that may be contributing to the mental health problems of asthmatics. This will be important in improving long-term overall health outcomes for those living with asthma.

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