OBJECTIVE: To determine the incidence of depression, anxiety, and suicidality in patients with psoriasis compared with the general population. DESIGN: A population-based cohort study using data collected as part of patient's electronic medical record from 1987 to 2002. SETTING: General Practice Research Database. PATIENTS: Analyses included 146 042 patients with mild psoriasis, 3956 patients with severe psoriasis, and 766 950 patients without psoriasis. Five controls without psoriasis were selected from the same practices and similar cohort entry dates as patients with psoriasis. MAIN OUTCOME MEASURE: Clinical diagnoses of depression, anxiety, and suicidality among patients. RESULTS: The adjusted hazard ratios (HRs) for receiving a diagnosis of depression, anxiety, and suicidality in patients with psoriasis compared with controls were 1.39 (95% confidence interval [CI], 1.37-1.41), 1.31 (95% CI, 1.29-1.34), and 1.44 (95% CI, 1.32-1.57), respectively. The adjusted HR of depression was higher in severe (HR, 1.72; 95% CI, 1.57-1.88) compared with mild psoriasis (HR, 1.38; 95% CI, 1.35-1.40). Younger patients with psoriasis had elevated HRs of outcomes compared with older patients with psoriasis. CONCLUSIONS: Patients with psoriasis have an increased risk of depression, anxiety, and suicidality. We estimate that in the United Kingdom, in excess of 10 400 diagnoses of depression, 7100 diagnoses of anxiety, and 350 diagnoses of suicidality are attributable to psoriasis annually. It is important for clinicians to evaluate patients with psoriasis for these conditions to improve outcomes. Future investigation should determine the mechanisms by which psoriasis is associated with psychiatric outcomes as well as approaches for prevention.
OBJECTIVE: To determine the incidence of depression, anxiety, and suicidality in patients with psoriasis compared with the general population. DESIGN: A population-based cohort study using data collected as part of patient's electronic medical record from 1987 to 2002. SETTING: General Practice Research Database. PATIENTS: Analyses included 146 042 patients with mild psoriasis, 3956 patients with severe psoriasis, and 766 950 patients without psoriasis. Five controls without psoriasis were selected from the same practices and similar cohort entry dates as patients with psoriasis. MAIN OUTCOME MEASURE: Clinical diagnoses of depression, anxiety, and suicidality among patients. RESULTS: The adjusted hazard ratios (HRs) for receiving a diagnosis of depression, anxiety, and suicidality in patients with psoriasis compared with controls were 1.39 (95% confidence interval [CI], 1.37-1.41), 1.31 (95% CI, 1.29-1.34), and 1.44 (95% CI, 1.32-1.57), respectively. The adjusted HR of depression was higher in severe (HR, 1.72; 95% CI, 1.57-1.88) compared with mild psoriasis (HR, 1.38; 95% CI, 1.35-1.40). Younger patients with psoriasis had elevated HRs of outcomes compared with older patients with psoriasis. CONCLUSIONS:Patients with psoriasis have an increased risk of depression, anxiety, and suicidality. We estimate that in the United Kingdom, in excess of 10 400 diagnoses of depression, 7100 diagnoses of anxiety, and 350 diagnoses of suicidality are attributable to psoriasis annually. It is important for clinicians to evaluate patients with psoriasis for these conditions to improve outcomes. Future investigation should determine the mechanisms by which psoriasis is associated with psychiatric outcomes as well as approaches for prevention.
Authors: Susan S Jick; James A Kaye; Catherine Vasilakis-Scaramozza; Luis A Garcia Rodríguez; Ana Ruigómez; Christoph R Meier; Raymond G Schlienger; Corri Black; Hershel Jick Journal: Pharmacotherapy Date: 2003-05 Impact factor: 4.705
Authors: Joel M Gelfand; Steven R Feldman; Robert S Stern; John Thomas; Tara Rolstad; David J Margolis Journal: J Am Acad Dermatol Date: 2004-11 Impact factor: 11.527
Authors: Joel M Gelfand; Daniel B Shin; Andrea L Neimann; Xingmei Wang; David J Margolis; Andrea B Troxel Journal: J Invest Dermatol Date: 2006-06-01 Impact factor: 8.551
Authors: Ryan Rivera-Oyola; Roselyn Stanger; Graham H Litchman; Quinn Thibodeaux; John Koo; Richard Fried; Gary Goldenberg; George Han; Sylvia Hsu; Leon Kircik; Melissa Knuckles; Andrea Murina; Jeffrey Weinberg; Jashin J Wu; Mark Lebwohl Journal: J Clin Aesthet Dermatol Date: 2020-12-01