Sanminder Singh1, Catherine Taylor2, Heather Kornmehl3, April W Armstrong4. 1. University of California Davis School of Medicine, Sacramento, California. 2. University of California Davis, Davis, California. 3. Drexel University College of Medicine, Philadelphia, Pennsylvania. 4. Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, California; Keck School of Medicine, University of Southern California, Los Angeles, California. Electronic address: aprilarmstrong@post.harvard.edu.
Abstract
BACKGROUND: Psoriasis is associated with psychiatric comorbidities; however, the relationship between psoriasis and suicidality is not well understood. OBJECTIVE: To perform a systematic review and meta-analysis that elucidates the relationship between psoriasis and suicidality. METHODS: Applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically searched the PubMed, EMBASE, PsycINFO, and Cochrane databases. We searched literature published between 1946 and 2017. RESULTS: We identified 18 studies with a total of 1,767,583 participants, of whom 330,207 had psoriasis. On the basis of random effects modeling, the pooled odds ratio (OR) for suicidal ideation among patients with psoriasis was 2.05 (95% confidence interval [CI], 1.54-2.74). Patients with psoriasis were more likely to exhibit suicidal behaviors (combined attempted and completed suicides) with a pooled OR of 1.26 (95% CI, 1.13-1.40). Subgroup analysis showed that patients with psoriasis were more likely to attempt suicides (OR, 1.32; 95% CI, 1.14-1.54) and complete suicide (OR, 1.20; 95% CI, 1.04-1.39) than those without psoriasis. More severe psoriasis and younger age were associated with greater likelihood of suicidality. LIMITATIONS: There are few studies examining suicidality in conjunction with psoriasis severity. CONCLUSIONS: Patients with psoriasis have a significantly higher likelihood of suicidal ideation, suicide attempts, and completed suicides. Among patients with psoriasis, those who are younger and whose psoriasis is more severe are at particular risk for suicidality.
BACKGROUND:Psoriasis is associated with psychiatric comorbidities; however, the relationship between psoriasis and suicidality is not well understood. OBJECTIVE: To perform a systematic review and meta-analysis that elucidates the relationship between psoriasis and suicidality. METHODS: Applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically searched the PubMed, EMBASE, PsycINFO, and Cochrane databases. We searched literature published between 1946 and 2017. RESULTS: We identified 18 studies with a total of 1,767,583 participants, of whom 330,207 had psoriasis. On the basis of random effects modeling, the pooled odds ratio (OR) for suicidal ideation among patients with psoriasis was 2.05 (95% confidence interval [CI], 1.54-2.74). Patients with psoriasis were more likely to exhibit suicidal behaviors (combined attempted and completed suicides) with a pooled OR of 1.26 (95% CI, 1.13-1.40). Subgroup analysis showed that patients with psoriasis were more likely to attempt suicides (OR, 1.32; 95% CI, 1.14-1.54) and complete suicide (OR, 1.20; 95% CI, 1.04-1.39) than those without psoriasis. More severe psoriasis and younger age were associated with greater likelihood of suicidality. LIMITATIONS: There are few studies examining suicidality in conjunction with psoriasis severity. CONCLUSIONS:Patients with psoriasis have a significantly higher likelihood of suicidal ideation, suicide attempts, and completed suicides. Among patients with psoriasis, those who are younger and whose psoriasis is more severe are at particular risk for suicidality.
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