Asthma and early smoking associated with high risk of panic disorder in adolescents and young adults

Meng Huan Wu, Wei Er Wang, Tsu Nai Wang, Ni Chi Lin, Mong Liang Lu, Leanna M.W. Lui, Roger S. McIntyre, Vincent Chin Hung Chen*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

5 Scopus citations


Purpose: Studies have reported a strong link between asthma and panic disorder. We conducted a 17-year community-based large cohort study to examine the relationship between asthma, early smoking initiation, and panic disorder during adolescence and early adulthood. Methods: A total of 162,766 participants aged 11–16 years were categorized into asthma and nonasthma groups at baseline and compared within the observation period. Covariates during late childhood or adolescence included parental education, cigarette smoking by family members of participants, and participant’s gender, age, alcohol consumption, smoking, and exercise habits. Data for urbanicity, prednisone use, allergic comorbidity, and Charlson comorbidity index were acquired from the National Health Insurance Research Database. The Cox proportional-hazards model was used to evaluate the association between asthma and panic disorder. Results: Our findings revealed that asthma increased the risk of panic disorder after adjustment for key confounders in the Cox proportional hazard regression model (adjusted HR: 1.70, 95% CI 1.28–2.26). Hospitalizations or visits to the emergency department for asthma exhibited a dose–response effect on the panic disorder (adjusted HR: 2.07, 95% CI 1.30–3.29). Patients with asthma with onset before 20 years of age who smoked during late childhood or adolescence had the greatest risk for panic disorder (adjusted HR: 4.95, 95% CI 1.23–19.90). Conclusions: Patients newly diagnosed with asthma had a 1.7-times higher risk of developing panic disorder. Smoking during late childhood or adolescence increased the risk for developing the panic disorder in patients with asthma.

Original languageEnglish
Pages (from-to)583-594
Number of pages12
JournalSocial Psychiatry and Psychiatric Epidemiology
Issue number3
StatePublished - 03 2022

Bibliographical note

Publisher Copyright:
© 2021, Springer-Verlag GmbH Germany, part of Springer Nature.


  • Adolescence
  • Asthma
  • Early adulthood
  • Panic disorder
  • Smoking


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