Healthcare Utilization, Physical and Psychiatric Comorbidities Before Self-Injurious Behavior in Patients with Asthma: A Nested Case-Control Study

Yen-Hsun Huang; Hsien-Chih Chiou; Chun-Hung Pan; I-Shuan Wang; Ya-Tang Liao; Sheng-Siang Su; Chiao-Chicy Chen; Chian-Jue Kuo

doi:10.2147/JAA.S449337

Healthcare Utilization, Physical and Psychiatric Comorbidities Before Self-Injurious Behavior in Patients with Asthma: A Nested Case-Control Study

J Asthma Allergy. 2024 May 7:17:411-420. doi: 10.2147/JAA.S449337. eCollection 2024.

Authors

Yen-Hsun Huang¹, Hsien-Chih Chiou¹, Chun-Hung Pan^{1

2}, I-Shuan Wang¹, Ya-Tang Liao³, Sheng-Siang Su¹, Chiao-Chicy Chen^{4

5

6}, Chian-Jue Kuo^{1

4

5}

Affiliations

¹ Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.
² Department of Psychology, National Chengchi University, Taipei, Taiwan.
³ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
⁴ Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁵ Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
⁶ Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.

Abstract

Background: Patients with asthma experience more physical, psychological, and financial burdens; a link between asthma and suicidality has been reported in research.

Purpose: This study analyzed the medical utilization and comorbidity before their self-injurious behavior in patients with asthma.

Methods: We enrolled 186,862 patients newly diagnosed with asthma between 1999 and 2013 from the National Health Insurance Research Database in Taiwan. A total of 500 case subjects had ever conducted self-injurious behaviors during the study period. Based on a nested case-control study, each case was matched with 10 controls derived from the asthma cohort to analyze differences between them and their medical use models.

Results: The results indicated that, compared to the control group, the cases presented higher frequencies of outpatient visits and hospitalizations. Regarding comorbidity, the cases had more cardiovascular diseases (adjusted odds ratio [aOR]=1.58; p<0.001), bipolar disorder (aOR=2.97; p<0.001), depression (aOR=4.44; p<0.001), and sleep disorder (aOR=1.83; p<0.001) than the controls.

Conclusion: The evidence-based information serves as a reference for medical staff to reduce the occurrence of self-injurious behavior in patients with asthma.

Keywords: asthma; medical utilization; physical comorbidity; psychiatric comorbidity; self-injurious behavior.

Grants and funding

This research was supported by grants from the National Science and Technology Council, Taiwan (grant numbers: MOST 108-2314-B-532-005 and 110-2314-B-532-003-MY3) and Taipei City Hospital (10201-62-008, and 10301-62-041). The funding organizations had no involvement in the study design, data collection, analysis, interpretation of data, writing of the report, or decision to submit the paper for publication.