Evaluation of changing trend in depression, suicidal ideation, and suicide attempts among adolescents with asthma and identification of associated factors: 11-year national data analysis in 788,411 participants.

OBJECTIVES: We identified associated factors for depression and suicidality in adolescents with asthma. METHODS: We obtained data from the annual Korea Youth Risk Behavior Web-based Surveys, completed from 2007 to 2017, as a stratified, multistage, clustered sample. Using self-reported questionnaires, students provided yes-or-no answers to questions addressing doctor-diagnosed asthma and self-experienced depression and suicidality. Associated factors for depression and suicidality were tested by logistic regression models after controlling for potential confounding factors. A total of 788,411 adolescents completed the survey. RESULTS: The prevalence of asthma was similar every year during the survey with 8.9% overall rate. Among them, the prevalence of depression (45.8-29.9%), suicidal ideation (28.6-15.5%), and suicide attempts (9.3-3.9%) decreased. Participants with asthma perceived themselves as unhealthier and unhappier, had more stress, sleep dissatisfaction, depression, suicidal ideation and suicide attempts than did subjects without asthma. In the multivariate model, perception of stress was most strongly associated with depression (adjusted Odds ratio: 4.78, 95% confidence intervals; 4.17-5.06) and suicide attempts (2.51; 1.67-2.93), whereas, perceived unhappiness was most strongly associated with suicidal ideation (4.81; 3.87-5.46) among adolescents with asthma. Asthma itself was also associated with depression, suicidal ideation and suicide attempts (1.12; 1.09-1.22, 1.18; 1.07-1.24, and 1.15; 1.04-1.19, respectively). CONCLUSION: Although the prevalence of asthma was similar every year, the prevalence of depression and suicidality among adolescents with asthma decreased. Nevertheless, clinical physicians should pay more attention to screen for depression and suicidality among adolescents with asthma, especially having associated factors.

Associated factors for depression, suicidal ideation and suicide attempt among asthmatic adolescents with experience of electronic cigarette use.

INTRODUCTION: While electronic cigarette (EC) use is rapidly increasing among asthmatic adolescents, little is known about the links between EC use and depression or suicidality. We assessed associated factors for depression and suicidality in asthmatic adolescents with experience of EC use. METHODS: We analyzed the data from the 11th to 13th Korea Youth Risk Behavior Web-based Surveys, which were completed from 2015 to 2017. Data were obtained from a stratified, multistage, clustered sample. Students supplied 'yes or no' answers to questions about previous asthma diagnosis by a doctor. Associated factors for depression and suicidality were evaluated by logistic regression models after controlling for potential confounding factors. We targeted 203336 adolescents, and 195847 completed the survey. RESULTS: The proportion of asthma among the respondents was 8.9%. The rate of experience of EC use was higher among asthmatic respondents than non-asthmatic respondents (10.3% vs 8.6%). Asthmatic respondents with experience of EC use had a much higher proportion of negative mental health states including depression and suicidality than subjects without EC experience. In our adjusted models, perception of stress was most strongly associated with depression (adjusted odds ratio, AOR=4.79; 95% CI: 4.12-5.58), and perception of unhappiness was most strongly associated with suicidal ideation (AOR=5.24; 95% CI: 4.51-6.09) and suicide attempt (AOR=4.37; 95% CI: 3.36-5.69). CONCLUSIONS: Many Korean asthmatic adolescents with experience of EC use report relatively high depression and suicidal behaviors. A multidisciplinary approach, including psychological help, may be required to prevent suicide among this population, especially those who report associated factors.

Identification of influencing factors for suicidal ideation and suicide attempts among adolescents: 11-year national data analysis for 788,411 participants.

Suicide is one of the most common causes of death in adolescents. This study identified trends in the prevalence of and factors influencing suicidal ideation and attempts among Korean adolescents. Data were drawn from the third through the thirteenth (2007-2017) annual Korean Youth Risk Behavior Web-based Surveys. Participants included stratified, multistage clustered samples selected from 400 middle schools and 400 high schools annually. Depression, suicidal ideation, and suicide attempts were binary dependent variables (requiring answers of yes or no). A total of 818,684 adolescents were targeted and 788,411 adolescents completed the survey. The prevalence rates of both suicidal ideation and attempts gradually decreased from 23.7% and 5.8%, respectively, in 2007 to 12.1% and 2.6%, respectively, in 2017. Overall, 16.8% of participants had suicidal ideation and 3.9% had suicide attempts during the survey period. During logistic regression analysis, depression was most strongly associated with suicidal ideation (adjusted odds ratio: 5.78 [95% confidence interval: 5.64-5.88]) and suicide attempts (adjusted odds ratio: 5.56, [95% confidence interval: 5.22-5.83]). Despite decreasing trends, the high rate of suicidal behaviors remains a critical public health problem. Depression most strongly predicts suicidal behaviors. Early interventions are essential to treat depression and reduce or prevent suicide.

Evaluation of a possible association between allergic rhinitis and depression, suicidal ideation, and suicide attempts among adolescents based on a nationwide cross-sectional study.

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.

Health-related behaviors and mental health states of South Korean adolescents with atopic dermatitis.

Atopic dermatitis (AD) is a common chronic skin disease with a negative influence on adolescent mental health state. We aimed to identify the influencing factors for mental health in adolescents with AD. We used data from the 13th Korean Youth Risk Behavior Web-based Survey (KYRBS) conducted in 2017. KYRBS data were obtained from a stratified, multistage, clustered sample. Participants responded to the question "have you ever been diagnosed with AD by a doctor?" and several yes/no questions about stress, depressive symptoms and suicidal ideation. Among 62 276 participants, the proportion of adolescents with AD was 25.0%. Compared with adolescents without AD, those with AD were significantly more likely to experience stress, depressive symptoms and suicidal ideation (P < 0.001) at rates of 59.1%, 27.8% and 13.9%, respectively. In the multivariate logistic regression model, subjective unhappiness was most strongly associated with stress in subjects with AD (adjusted odds ratio [aOR], 7.34; 95% confidence interval [CI], 5.87-9.18), while depression (aOR, 9.83; 95% CI, 7.85-11.32) and suicidal ideation (aOR, 5.70; 95% CI, 5.01-6.48) were reciprocally the most important risk factors in adolescents with AD. AD in adolescents is associated with a higher prevalence of stress, depressive symptoms and suicidal ideation. It is important for pediatricians to watch for these risks and to screen for suicidality in adolescents with AD.

Association of atopic dermatitis with suicide risk among 788,411 adolescents: A Korean cross-sectional study.

BACKGROUND: Atopic dermatitis (AD) is known to negatively influence the mental health of patients. However, only a few studies have explored the influencing factors for psychiatric problems among adolescents with AD. OBJECTIVE: To assess the association of AD and suicidal behaviors among adolescents by analyzing data from the 3rd through the 13th annual Korean Youth Risk Behavior Web-based Surveys (completed from 2007 to 2017). METHODS: Survey data were obtained from a stratified, multistage, clustered sample. Students self-reported AD if they had received a diagnosis of AD by a physician. Influencing factors for suicidal behaviors were tested by logistic regression models. RESULTS: A total of 788,411 adolescents completed the survey. The proportion of participants with AD was 22.2%. Those reporting suicide ideation and suicide attempts were 19.0%, and 4.5%, respectively. Compared with adolescents without AD, those with AD were more likely to be female, to skip breakfast less frequently, to exercise less frequently, to drink less alcohol, and to not be current smokers and were statistically significantly more likely to have negative mental health states. In the multivariable model, perceived unhappiness and suicidal ideation were the strongest influencing factors for suicidal ideation (adjusted odds ratio, 4.90; 95% CI, 4.31-5.57) and for suicidal attempts (adjusted odds ratio, 48.01; 95% CI, 42.69-53.09), respectively. CONCLUSION: Adolescents with AD had a meaningful prevalence of suicidal behaviors. Although further research is needed to clarify this association, adolescents with AD with influencing factors for negative mental health state may need intervention from practitioners who use a multidisciplinary team approach to prevent suicide.

Influencing Factors for Influenza Vaccination among South Korean Adolescents with Asthma Based on a Nationwide Cross-Sectional Study.

BACKGROUND: Influenza viral infection is a major public health problem with significant morbidity and mortality.Asthma is a risk factor for developing serious complications related to influenza infection. OBJECTIVE: We explored factors associated with influenza vaccination coverage among adolescents with asthma. METHODS: Data were obtained from 62,276 participants in the 13th Korean Youth Risk Behavior Web-Based Survey (KYRBS) conducted in 2017. KYRBS data were obtained from a stratified, multistage, clustered sample. We used multiple logistic regression analyses to identify variables potentially related to influenza vaccination in adolescents with asthma. RESULTS: The proportion of asthma was 8.8%, and the influenza vaccination rate overall was 37.9%. It was 41.8% in the asthma group and 37.5% in the nonasthma group (p < 0.001). After regression, male sex (odds ratio (OR) = 1.45; 95% CI 1.35-1.55), a high socioeconomic status (OR = 1.12; 95% CI 1.05-1.19), residence at an orphanage (OR = 1.93; 95% CI 1.38-2.29), regular breakfast consumption (OR = 1.09; 95% CI 1.02-1.17), and subjective good health (OR = 2.39; 95% CI 1.69-3.39) were associated with increased influenza vaccination, whereas current smoking (OR = 0.87; 95% CI 0.67-0.96) and a depressive mood (OR = 0.77; 95% CI 0.64-0.95) were inversely associated in adolescents with asthma. CONCLUSION: It is important to improve influenza vaccination in adolescents with asthma, especially females, those with a low socioeconomic status, independent residents, breakfast skippers, current smokers, and those who consider themselves unhealthy and have depressive moods.