Psychiatric comorbidities in psoriasis not directly linked to increased suicidality

No significant increased risk was found for suicidal behavior in a retrospective group of patients with psoriasis and potential concomitant psoriatic arthritis compared with control patients, according to findings from a nationwide study in Taiwan published in American Journal of Clinical Dermatology.

“The relation between psoriasis and mental illness may be more complicated than previously thought,” Shu-Hui Wang, MD, of the department of dermatology at Far Eastern Memorial Hospital and the Graduate Institute of Applied Science and Engineering at Fu Jen Catholic University, both in New Taipei, Taiwan, and colleagues wrote. “Psychiatric comorbidities, for example, depression, stigmatization and stress, are not always proportional to or predicted by the severity of psoriasis.”

In the nationwide retrospective cohort study, researchers utilized the National Health Insurance Research Database and included 169,909 patients with psoriasis, of whom 13,959 had concomitant psoriatic arthritis, along with 169,909 matched controls who had never received a diagnosis of psoriasis.

Subgroups were analyzed according to severity of psoriasis. The severe psoriasis group was defined as patients who had ever received oral medications, phototherapy and biologics. Another subgrouping was assigned based on the absence or presence of psoriatic arthritis.

Suicidal behavior was defined by the claim data with the diagnoses of suicide and self-inflicted injury in the database and was identified among 104 patients with psoriasis and 89 control patients.

Although the psoriasis group appeared to have a higher cumulative incidence for suicidal behavior than control patients, the researchers found no significant difference between the two groups.

Additionally, after adjusting for age and sex, the group with psoriasis did not have a significantly increased risk for suicidal behavior (HR = 1.17; 95% CI, 0.88-1.55).

In the competitive risk model, the risk for suicide did not differ between the group with psoriasis and the control group (aHR = 1.09; 95% CI, 0.82-1.45).

Severe vs. mild psoriasis groups did not have a significantly greater cumulative incidence for suicidal behavior. Furthermore, the group with psoriasis alone showed no significant difference in suicidal behavior compared with those with psoriatic arthritis nor with the control group.

“Our study indicates psychiatric comorbidities among psoriasis patients cannot be directly translated to increased suicidality,” Wang and colleagues wrote. – by Abigail Sutton

Disclosures: The authors report no relevant financial disclosures.