Ching-Chi Chi1,2,3, Ting-Hao Chen4, Shu-Hui Wang5,6, Tao-Hsin Tung7,8. 1. Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan. 2. Department of Dermatology, Chang Gung Memorial Hospital, Chiayi, Chiayi, Taiwan. 3. College of Medicine, Chang Gung University, Taoyuan, Taiwan. 4. Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan. 5. Department of Dermatology, Far Eastern Memorial Hospital, New Taipei, Taiwan. 6. Graduate Institute of Applied Science and Engineering, College of Science and Engineering, Fu Jen Catholic University, New Taipei, Taiwan. 7. Department of Medical Research and Education, Cheng Hsin General Hospital, 45, Cheng Hsin St, Pai-Tou, Taipei, 11220, Taiwan. ch2876@chgh.org.tw. 8. Department of Public Health, Fu Jen Catholic University, New Taipei, Taiwan. ch2876@chgh.org.tw.
Abstract
BACKGROUND: Psoriasis has been associated with psychiatric disorders such as depression and anxiety, but its relationship with suicidality (including suicide, suicide attempt, and suicidal ideation) is unclear. OBJECTIVE: Our objective was to assess the risk of suicide, suicide attempt, suicidal ideation, and suicidality in people with psoriasis. METHODS: We conducted a systematic review and meta-analysis of cohort studies examining the risk of suicide, suicide attempt, suicidal ideation, and suicidality in people with psoriasis. We searched the Cochrane Library, PubMed, and EMBASE from inception to 24 March 2017. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreement was resolved by discussion with a third author. RESULTS: Five population-based cohort studies were included and considered to be of high quality. We found no increase in the risk of suicide (risk ratio [RR] 1.13; 95% confidence interval [CI] 0.87-1.46), suicide attempt (RR 1.25; 95% CI 0.89-1.75), or suicidality (RR 1.26; 95% CI 0.97-1.64) among people with psoriasis. In the stratified analysis, we also found no increase in suicide, suicide attempt, and suicidality among people with either severe or mild psoriasis. CONCLUSIONS: The available limited, very low-quality evidence does not support an association between psoriasis and suicidal thought and behavior. Further studies that provide data for different age and sex groups are needed to clarify whether a subgroup of patients with psoriasis has an elevated risk of suicidality.
BACKGROUND:Psoriasis has been associated with psychiatric disorders such as depression and anxiety, but its relationship with suicidality (including suicide, suicide attempt, and suicidal ideation) is unclear. OBJECTIVE: Our objective was to assess the risk of suicide, suicide attempt, suicidal ideation, and suicidality in people with psoriasis. METHODS: We conducted a systematic review and meta-analysis of cohort studies examining the risk of suicide, suicide attempt, suicidal ideation, and suicidality in people with psoriasis. We searched the Cochrane Library, PubMed, and EMBASE from inception to 24 March 2017. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreement was resolved by discussion with a third author. RESULTS: Five population-based cohort studies were included and considered to be of high quality. We found no increase in the risk of suicide (risk ratio [RR] 1.13; 95% confidence interval [CI] 0.87-1.46), suicide attempt (RR 1.25; 95% CI 0.89-1.75), or suicidality (RR 1.26; 95% CI 0.97-1.64) among people with psoriasis. In the stratified analysis, we also found no increase in suicide, suicide attempt, and suicidality among people with either severe or mild psoriasis. CONCLUSIONS: The available limited, very low-quality evidence does not support an association between psoriasis and suicidal thought and behavior. Further studies that provide data for different age and sex groups are needed to clarify whether a subgroup of patients with psoriasis has an elevated risk of suicidality.
Entities:
Keywords:
Included Study; Psoriasis; Risk Ratio; Suicidal Ideation; Suicide Attempt
Authors: C Elise Kleyn; Peter S Talbot; Nehal N Mehta; Francesca Sampogna; Chris Bundy; Darren M Ashcroft; Alexa B Kimball; Peter C M van de Kerkhof; Christopher E M Griffiths; Fernando Valenzuela; Joelle M van der Walt; Tsion Aberra; Lluís Puig Journal: Acta Derm Venereol Date: 2020-01-07 Impact factor: 3.875