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J Eur Acad Dermatol Venereol. 2017 Jul;31(7):1168-1175. doi: 10.1111/jdv.14175. Epub 2017 Apr 21.

The risk of depression, suicidal ideation and suicide attempt in patients with psoriasis, psoriatic arthritis or ankylosing spondylitis.

Author information

1
Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
2
Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA.
3
Quantitative Safety & Epidemiology, Novartis Pharma AG, Basel, Switzerland.
4
Global Medical Affairs, Novartis Pharma AG, Basel, Switzerland.
5
University of Illinois at Chicago College of Medicine, Chicago, IL, USA.
6
Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Hellerup, Denmark.
7
Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.

Abstract

BACKGROUND:

Sparse information is available concerning mental health issues in psoriasis, psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients.

OBJECTIVE:

To estimate risk of depression, suicidal ideation and suicide attempt in patients with psoriasis, PsA and AS, respectively, compared with the general population.

METHODS:

This population-based cohort study analysed 36 214 psoriasis patients, 5138 PsA patients and 1878 AS patients who were frequency-matched with a general population cohort. Annual incidence rate of depression, suicidal ideation and suicide attempt was calculated separately for psoriasis, PsA and AS.

RESULTS:

There was an increased risk of depression in the three cohorts; adjusted IRR: psoriasis, 1.14 (95% CI, 1.11, 1.17); PsA, 1.22 (95% CI, 1.16, 1.29); AS, 1.34 (95% CI, 1.23, 1.47). There was no significantly increased risk for suicidal ideations or suicide attempt among psoriasis, PsA or AS patients.

LIMITATIONS:

Patients were not excluded if previously diagnosed with depression, suicidal ideation or suicide attempt. Suicide attempt and completed suicide analyses were not adjusted for presence of depression. Use of systemic psoriasis treatment to measure severe psoriasis could lead to psoriasis severity misclassification.

CONCLUSION:

The risk of depression, but not suicidal ideation or suicide attempt, was significantly increased in patients with psoriasis, PsA and AS.

PMID:
28214371
DOI:
10.1111/jdv.14175
[Indexed for MEDLINE]

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