Risk for Suicidal Behavior Among Psoriasis Patients: A Nationwide Cohort Study
Journal
American Journal of Clinical Dermatology
Journal Volume
21
Journal Issue
3
Pages
431-439
Date Issued
2020
Author(s)
Abstract
Background: The link between psoriasis and suicidality remains elusive and understudied. Objective: The aim was to assess the risk of suicidal behavior in psoriasis patients. Methods: We used Taiwan’s National Health Insurance Research Database to conduct a nationwide retrospective cohort study to examine the risk for suicidal behavior among psoriasis patients. We performed subgroup analyses based on the severity of psoriasis and psoriatic arthritis. Results: We included 169,909 psoriasis patients (including 13,959 with concomitant psoriatic arthritis and 155,950 with psoriasis alone) and 169,909 matched nonpsoriasis controls. Suicidal behavior occurred in 104 and 89 subjects in the psoriasis group and nonpsoriasis controls, respectively; we found no significantly increased risk for suicidal behavior among psoriasis patients when compared to nonpsoriasis controls [adjusted hazard ratio (HR) 1.17, 95% confidence interval (CI) 0.88?1.55]. The subgroup analysis showed no significantly increased risk for suicidal behavior in both the severe psoriasis group (adjusted HR 0.92, 95% CI 0.51–1.64) and the mild psoriasis group (adjusted HR 1.26, 95% CI 0.91?1.75) when compared to nonpsoriasis controls. Also, we found no significant increased risk for suicidal behavior in the group of psoriasis patients who also had psoriatic arthritis (adjusted HR 2.00, 95% CI 0.68?5.85) and in the group of patients with psoriasis alone (adjusted HR 1.12, 95% CI 0.83?1.50) when compared to nonpsoriasis controls. Conclusion: In a Taiwanese setting, no link between psoriasis or psoriatic arthritis and suicidal behavior was detected. ? 2019, Springer Nature Switzerland AG.
SDGs
Other Subjects
adalimumab; cyclosporine; etanercept; etretin; methotrexate; ustekinumab; adult; alcoholism; anxiety disorder; Article; cohort analysis; controlled study; depression; disease severity; female; human; major clinical study; male; malignant neoplasm; middle aged; outcome assessment; phototherapy; priority journal; psoriasis; psoriatic arthritis; retrospective study; suicidal behavior; Taiwan; aged; complication; epidemiology; factual database; follow up; incidence; information processing; psoriasis; psoriatic arthritis; psychology; risk assessment; severity of illness index; suicide; Adult; Aged; Arthritis, Psoriatic; Databases, Factual; Datasets as Topic; Female; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Psoriasis; Retrospective Studies; Risk Assessment; Severity of Illness Index; Suicide; Taiwan
Publisher
Adis
Type
journal article