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Risk for Suicidal Behavior Among Psoriasis Patients: A Nationwide Cohort Study

  • Shu-Hui Wang
  • Jui Wang
  • Ching-Chi ChiEmail author
  • Yu-Sheng Lin
  • Shih-Cheng Liao
  • Pei-En Chen
  • Tao-Hsin TungEmail author
Original Research Article

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.

Notes

Acknowledgements

We would like to thank the Sunflower Statistical Consulting Company, Kaohsiung, Taiwan for statistical advice.

Compliance with Ethical Standards

Funding

This study was supported by the Far Eastern Memorial Hospital, Taiwan (FEMH-2018-C-030).

Conflict of interest

Dr. Wang, Mr. Wang, Prof. Chi, Dr. Lin, Dr. Liao, Ms. Chen, and Dr. Tung declare no conflict of interest.

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of DermatologyFar Eastern Memorial HospitalNew TaipeiTaiwan
  2. 2.Graduate Institute of Applied Science and Engineering, College of Science and EngineeringFu Jen Catholic UniversityNew TaipeiTaiwan
  3. 3.Institute of Epidemiology and Preventive Medicine, College of Public HealthNational Taiwan UniversityTaipeiTaiwan
  4. 4.Department of DermatologyChang Gung Memorial Hospital, LinkouTaoyuanTaiwan
  5. 5.College of MedicineChang Gung UniversityTaoyuanTaiwan
  6. 6.Division of Cardiology, Department of MedicineChang Gung Memorial HospitalChiayiTaiwan
  7. 7.Department of Psychiatry, College of MedicineNational Taiwan University HospitalTaipeiTaiwan
  8. 8.Department of Medical Research and EducationCheng Hsin General HospitalTaipeiTaiwan
  9. 9.Hechi Third People’s HospitalHechiChina

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