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. 1996 Jan 13;312(7023):79–82. doi: 10.1136/bmj.312.7023.79

Increased morbidity and mortality related to asthma among asthmatic patients who use major tranquillisers.

K S Joseph 1, L Blais 1, P Ernst 1, S Suissa 1
PMCID: PMC2349744  PMID: 8555932

Abstract

OBJECTIVE--To assess the potentially increased risk of death or near death from asthma in asthmatic patients with psychosis. DESIGN--Case-control study. SETTING--The computerised health databases of the Canadian province of Saskatchewan. SUBJECTS--131 cases of death or near death from asthma identified within a cohort of asthmatic patients; 3930 matched non-cases. EXPOSURE AND OUTCOME MEASURES--The exposure of interest was the use of major tranquillisers in the period before an outcome event. Outcomes included death or near death from asthma. RESULTS--Crude analyses showed that asthmatic patients who had used major tranquillisers in the previous 12 months were at a 3.2 (95% confidence interval 1.4 to 7.5) times greater risk of death or near death from asthma than asthmatic patients who did not use major tranquillisers. Past users of major tranquillisers who had recently discontinued use were at a particularly high risk (relative risk 6.6; 2.5 to 17.6). Adjustment for use of antiasthma drugs and other confounders abolished this excess risk. CONCLUSIONS--Asthmatic patients who use major tranquillisers seem to be at an increased risk of death or near death from asthma. Physicians treating asthmatic patients with a history of use of major tranquillisers should exercise greater caution with regard to management of such patients.

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Selected References

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  1. Banks T. A difficult combination. Aust Fam Physician. 1993 Aug;22(8):1467-9, 1471. [PubMed] [Google Scholar]
  2. Buda M., Tsuang M. T., Fleming J. A. Causes of death in DSM-III schizophrenics and other psychotics (atypical group). A comparison with the general population. Arch Gen Psychiatry. 1988 Mar;45(3):283–285. doi: 10.1001/archpsyc.1988.01800270101012. [DOI] [PubMed] [Google Scholar]
  3. Crane J., Pearce N., Burgess C., Woodman K., Robson B., Beasley R. Markers of risk of asthma death or readmission in the 12 months following a hospital admission for asthma. Int J Epidemiol. 1992 Aug;21(4):737–744. doi: 10.1093/ije/21.4.737. [DOI] [PubMed] [Google Scholar]
  4. Fritz G. K., Rubinstein S., Lewiston N. J. Psychological factors in fatal childhood asthma. Am J Orthopsychiatry. 1987 Apr;57(2):253–257. doi: 10.1111/j.1939-0025.1987.tb03535.x. [DOI] [PubMed] [Google Scholar]
  5. Masterson E., O'Shea B. Smoking and malignancy in schizophrenia. Br J Psychiatry. 1984 Oct;145:429–432. doi: 10.1192/bjp.145.4.429. [DOI] [PubMed] [Google Scholar]
  6. Miettinen O. S. Stratification by a multivariate confounder score. Am J Epidemiol. 1976 Dec;104(6):609–620. doi: 10.1093/oxfordjournals.aje.a112339. [DOI] [PubMed] [Google Scholar]
  7. Miettinen O. S. The clinical trial as a paradigm for epidemiologic research. J Clin Epidemiol. 1989;42(6):491–498. doi: 10.1016/0895-4356(89)90143-1. [DOI] [PubMed] [Google Scholar]
  8. Miettinen O. Estimability and estimation in case-referent studies. Am J Epidemiol. 1976 Feb;103(2):226–235. doi: 10.1093/oxfordjournals.aje.a112220. [DOI] [PubMed] [Google Scholar]
  9. Miller B. D. Depression and asthma: a potentially lethal mixture. J Allergy Clin Immunol. 1987 Sep;80(3 Pt 2):481–486. doi: 10.1016/0091-6749(87)90080-7. [DOI] [PubMed] [Google Scholar]
  10. Mortensen P. B. The incidence of cancer in schizophrenic patients. J Epidemiol Community Health. 1989 Mar;43(1):43–47. doi: 10.1136/jech.43.1.43. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Rea H. H., Scragg R., Jackson R., Beaglehole R., Fenwick J., Sutherland D. C. A case-control study of deaths from asthma. Thorax. 1986 Nov;41(11):833–839. doi: 10.1136/thx.41.11.833. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Saugstad L. F., Odegård O. Mortality in psychiatric hospitals in Norway 1950--74. Acta Psychiatr Scand. 1979 Apr;59(4):431–447. doi: 10.1111/j.1600-0447.1979.tb04485.x. [DOI] [PubMed] [Google Scholar]
  13. Sonin L., Patterson R. Corticosteroid-dependent asthma and schizophrenia. Arch Intern Med. 1984 Mar;144(3):554–556. [PubMed] [Google Scholar]
  14. Spitzer W. O., Suissa S., Ernst P., Horwitz R. I., Habbick B., Cockcroft D., Boivin J. F., McNutt M., Buist A. S., Rebuck A. S. The use of beta-agonists and the risk of death and near death from asthma. N Engl J Med. 1992 Feb 20;326(8):501–506. doi: 10.1056/NEJM199202203260801. [DOI] [PubMed] [Google Scholar]
  15. Strunk R. C., Mrazek D. A., Fuhrmann G. S., LaBrecque J. F. Physiologic and psychological characteristics associated with deaths due to asthma in childhood. A case-controlled study. JAMA. 1985 Sep 6;254(9):1193–1198. [PubMed] [Google Scholar]
  16. Suissa S., Ernst P., Boivin J. F., Horwitz R. I., Habbick B., Cockroft D., Blais L., McNutt M., Buist A. S., Spitzer W. O. A cohort analysis of excess mortality in asthma and the use of inhaled beta-agonists. Am J Respir Crit Care Med. 1994 Mar;149(3 Pt 1):604–610. doi: 10.1164/ajrccm.149.3.8118625. [DOI] [PubMed] [Google Scholar]
  17. Tyrer P. J. Use of beta-blocking drugs in psychiatry and neurology. Drugs. 1980 Oct;20(4):300–308. doi: 10.2165/00003495-198020040-00004. [DOI] [PubMed] [Google Scholar]
  18. Weinberg C. R. Toward a clearer definition of confounding. Am J Epidemiol. 1993 Jan 1;137(1):1–8. doi: 10.1093/oxfordjournals.aje.a116591. [DOI] [PubMed] [Google Scholar]

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