Risk of self-harm and nonfatal suicide attempts, and completed suicide in patients with psoriasis: a population-based cohort study

Egeberg, Alexander; Hansen, Peter Riis; Gislason, Gunnar; Skov, Lone; Mallbris, Lotus

doi:10.1111/bjd.14633

Cited by 51 publications

(66 citation statements)

References 30 publications

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“…A more recent, population‐based cohort from Denmark found no increased risk of self‐harm or non‐fatal suicidal attempt in patients with mild psoriasis (incidence rate ratio (IRR) 1.01, 95% CI 0.17–2.01), but a significantly increased risk in severe psoriasis (IRR 1.69, 95% CI 1.00–2.84), albeit that the result was non‐significant after controlling for PsA. Additionally, they found no increased risk of suicide in mild (IRR 1.05, 95% CI 0.84–1.32) or severe psoriasis (IRR 0.78, 95% CI 0.45–1.36) …”

Section: Discussionmentioning

confidence: 96%

“…Patients with a diagnosis of psoriasis were classified into two categories: severe disease if they received a prescription of at least one systemic therapy or phototherapy during the study period and mild disease if they received a code for psoriasis but with no treatment ever recorded, or received only topical treatment during the study period. This classification used to define moderate or severe psoriasis is generally used and has been validated in similar database studies …”

Section: Methodsmentioning

confidence: 99%

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

Penfold

Primatesta

et al. 2017

Acad Dermatol Venereol

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Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

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

Penfold

Primatesta

et al. 2017

Acad Dermatol Venereol

Self Cite

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show abstract

“…A population-based study of 57,502 and 11,009 Danish adults with mild and severe psoriasis, respectively, reported 280 patients with suicide attempts and 574 cases of completed suicide. Interestingly, after adjusting for confounding factors, an increased risk of suicide attempts was only seen in severe but not mild cases of psoriasis [13]. A cross-sectional study of 102 patients with psoriasis demonstrated a significant level of stigmatization attributed to their chronic disease [14].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Association of Psoriasis with Psychiatric Hospitalization in United States Children and Adults

et al. 2019

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Background: Psoriasis is associated with psychosocial distress. Little is known about the relationship between psoriasis and mental health (MH) emergencies. Objective: To examine the associations of psoriasis and MH hospitalizations in the USA. Methods: Data from the 2002–2012 National Inpatient Sample were analyzed, including an approximately 20% sample of all US hospitalizations (n = 87,053,155 children and adults). Results: Hospitalization for MH disorders occurred more commonly in those with psoriasis compared to those without psoriasis (4.04 vs. 2.21%). In multivariable logistic regression models, psoriasis was associated with higher odds of admission for any MH disorder overall (adjusted odds ratio [95% confidence interval]: 2.32 [2.24–2.41]), as well as 9 of the 15 MH-specific disorders examined. Associated MH disorders included: anxiety, schizophrenia, personality disorder, depression, substance use disorders, history of MH disorder, alcohol-related disorders, adjustment disorders, and cognitive disorders. Children with versus those without psoriasis were also more likely to have a primary hospitalization for any MH disorder (2.82 [2.24–3.56]). Psoriasis inpatients were also more likely to have a primary hospitalization for any MH disorder compared to those with alopecia areata (1.99 [1.45–2.74]) or hidradenitis suppurativa (3.97 [3.49–4.52]). Psoriasis patients hospitalized with any MH disorder had higher mean [95% confidence interval] cost of inpatient care (USD 11,004 [10,846–11,241] vs. 9,547 [8,730–10,364]; p < 0.0001) compared to those without psoriasis, with USD 1,610,860 excess costs annually, with the majority of the costs coming from depression and mood disorders. Conclusions: Children and adults with psoriasis had increased hospitalization for multiple MH disorders, which were associated with a considerable financial burden.

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“…CHS is the largest managed care organization in Israel, and served a population of about 4 200 000 enrollees during the year 2013 . The magnitude of the CHS databases allows for the assessment of larger patient populations compared with other large‐scale epidemiological studies assessing the prevalence of mental illness in psoriasis patients . The CHS has a comprehensive database with continuous real‐time input from healthcare providers, pharmacies, medical care facilities and administrative computerized operating systems.…”

Section: Methodsmentioning

confidence: 99%

The association between the socioeconomic status and anxiety–depression comorbidity in patients with psoriasis: a nationwide population‐based study

Bitan

Krieger

Comaneshter

et al. 2019

Acad Dermatol Venereol

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Background Numerous studies have indicated that comorbid anxiety and depression are associated with a more severe course of illness. Yet generally, the study of the effect of psoriasis on patients’ mental health has considered anxiety and depression to be separate states. Objective To measure the association between psoriasis and anxiety, depression and anxiety–depression co‐occurrence among patients according to their socioeconomic statuses (SES). Methods A nationwide population‐based study of psoriasis patients and age and gender frequency‐matched controls (n = 255 862) was designed. Diagnostic data were obtained from Clalit Health Services, the largest managed care organization in Israel. This database was established using continuous real‐time input from healthcare providers, pharmacies, medical care facilities and administrative computerized operating systems. Results After controlling for demographic and clinical variables, psoriasis was associated with anxiety (OR 1.11, 95% CI 1.01–1.23, P < 0.05), depression (OR 1.17, 95% CI 1.08–1.26, P < 0.001), and anxiety and depression co‐occurrence (OR 1.32, 95% CI 1.21–1.45, P < 0.001) among patients with low SES, yet was associated only with anxiety (OR 1.15 95% CI 1.04–1.27, P < 0.001) but not depression or comorbid anxiety–depression among patients with high SES. Survival analyses indicated that between the ages of 40 and 60, the cumulative probability of psoriasis patients with low SES to suffer from anxiety, depression and their co‐occurrence inclined more sharply with age as compared to psoriasis patients with high SES. Conclusions As psoriasis patients with low SES are prone to suffer from more severe courses of anxiety and depression, the choice of treatment of psoriasis should address the SES as well as the underlying psychiatric disease.

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Risk of self-harm and nonfatal suicide attempts, and completed suicide in patients with psoriasis: a population-based cohort study

Cited by 51 publications

References 30 publications

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

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

Association of Psoriasis with Psychiatric Hospitalization in United States Children and Adults

The association between the socioeconomic status and anxiety–depression comorbidity in patients with psoriasis: a nationwide population‐based study

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