U Matterne1, S E Baumeister2,3, C J Apfelbacher1. 1. Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany. 2. Chair of Epidemiology, LMU Munich, UNIKA-T Augsburg, Augsburg, Germany. 3. Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Abstract
AIM: Chi et al.1 and Singh et al.2 each conducted a systematic review and meta-analysis of observational studies examining the relationship between suicidality and psoriasis. SETTING AND DESIGN: Chi et al. included only cohort studies while Singh et al. included cohort, cross-sectional and case-control studies. PRIMARY EXPOSURE AND OUTCOME: The primary outcome, suicidality, was assessed in people with psoriasis (exposure) and people without psoriasis. Analyses were separated for suicidal ideation and behaviour. RESULTS: Chi et al. included five population-based cohort studies that were considered to be of high quality according to the Newcastle-Ottawa Scale (NOS). They found no significant 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. Singh et al. included 18 studies that were rated to be of medium quality to high quality according to the NOS. They found a pooled odds ratio (OR) of 2·05 (95% CI 1·54-2·74) for suicidal ideation among patients with psoriasis. For suicidal behaviours (combined attempted and completed suicides) a pooled OR of 1·26 (95% CI 1·13-1·40) was obtained, suggesting a higher risk of these behaviours in people with psoriasis. Subgroup analysis showed that patients with psoriasis were more likely to attempt suicide (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. CONCLUSIONS: Singh et al. concluded that patients with psoriasis have a significantly higher risk of suicidal ideation, suicide attempts and completed suicides, while Chi et al. concluded that the available, limited, very low-quality evidence does not support the notion of an association between psoriasis on the one hand, and suicide, suicidal ideation and suicide attempts on the other.
AIM: Chi et al.1 and Singh et al.2 each conducted a systematic review and meta-analysis of observational studies examining the relationship between suicidality and psoriasis. SETTING AND DESIGN: Chi et al. included only cohort studies while Singh et al. included cohort, cross-sectional and case-control studies. PRIMARY EXPOSURE AND OUTCOME: The primary outcome, suicidality, was assessed in people with psoriasis (exposure) and people without psoriasis. Analyses were separated for suicidal ideation and behaviour. RESULTS: Chi et al. included five population-based cohort studies that were considered to be of high quality according to the Newcastle-Ottawa Scale (NOS). They found no significant 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. Singh et al. included 18 studies that were rated to be of medium quality to high quality according to the NOS. They found a pooled odds ratio (OR) of 2·05 (95% CI 1·54-2·74) for suicidal ideation among patients with psoriasis. For suicidal behaviours (combined attempted and completed suicides) a pooled OR of 1·26 (95% CI 1·13-1·40) was obtained, suggesting a higher risk of these behaviours in people with psoriasis. Subgroup analysis showed that patients with psoriasis were more likely to attempt suicide (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. CONCLUSIONS: Singh et al. concluded that patients with psoriasis have a significantly higher risk of suicidal ideation, suicide attempts and completed suicides, while Chi et al. concluded that the available, limited, very low-quality evidence does not support the notion of an association between psoriasis on the one hand, and suicide, suicidal ideation and suicide attempts on the other.
Authors: Deborah Dal Farra; Alice Valdesalici; Giancarlo Zecchinato; Alfio De Sandre; Diego Saccon; Pierluigi Simonato; Ornella Corazza; Giovanni Martinotti; Andrew L Smith; Marco Solmi Journal: Int J Environ Res Public Health Date: 2022-01-14 Impact factor: 3.390