The risk of depression, suicidal ideation, and suicide attempt in patients with psoriasis, psoriatic arthritis, or ankylosing spondylitis

Abstract

Background

Sparse information is available concerning mental health issues in psoriasis, psoriatic arthritis (PsA), and ankylosing spondylitis (AS) patients.

Objective

To estimate risk of depression, suicidal ideation, and suicide attempt in patients with psoriasis, PsA, and AS, respectively, compared with the general population.

Methods

This population-based cohort study analyzed 36,214 psoriasis patients, 5,138 PsA patients, and 1,878 AS patients who were frequency-matched with a general population cohort. Annual incidence rate of depression, suicidal ideation, and suicide attempt was calculated separately for psoriasis, PsA and AS.

Results

There was an increased risk of depression in the three cohorts; adjusted IRR: psoriasis, 1.14 (95% CI, 1.11, 1.17); PsA, 1.22 (95% CI, 1.16, 1.29); AS, 1.34 (95% CI, 1.23, 1.47). There was no significantly increased risk for suicidal ideations or suicide attempt among psoriasis, PsA, or AS patients.

Limitations

Patients were not excluded if previously diagnosed with depression, suicidal ideation, or suicide attempt. Suicide attempt and completed suicide analyses were not adjusted for presence of depression. Use of systemic psoriasis treatment to measure severe psoriasis could lead to psoriasis severity misclassification.

Conclusion

The risk of depression, but not suicidal ideation or suicide attempt, was significantly increased in patients with psoriasis, PsA, and AS.

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