Data from a systematic review and meta-analysis showed patients with psoriasis were twice as likely to consider suicide than the general population. Additionally, psoriasis was significantly associated with both attempted and completed suicide, researchers reported.
A search of literature published between 1946 and 2017 using PubMed, Embase, PsycInfo and Cochrane databases returned 18 studies comprising 1,767,583 participants, with 330,207 of those reporting psoriasis.
Results of a random effects model indicated that suicide ideation was significantly increased in the psoriasis group (OR = 2.05; 95% CI, 1.54-2.74). Suicidal behaviors — defined as a combination of attempted and completed suicides — also were increased in the psoriasis group (OR = 1.26; 95% CI, 1.13-1.40).
Further subgroup analysis results showed that both attempted suicides (OR = 1.32; 95% CI, 1.14-1.54) and completed suicides (OR = 1.20; 95% CI, 1.04-1.39) were elevated in patients with psoriasis compared with the non-psoriasis group.
Patients with psoriasis attempted suicide at an incidence rate of 1.43 per 10,000 person-years, compared with 1.00 per 10,000 person-years among matched controls. Completed suicide rates were 2.03 per 10,000 person-years in the psoriasis group and 1.64 per 10,000 among matched controls.
In three studies stratifying patients for age, results showed that younger patients carried an increased likelihood of suicidality. Particularly, one study demonstrated the risk was higher among patients in their 20s vs. patients in their 60s (HR = 1.83; 95% CI, 1.64-2.05 vs. HR = 1.04; 95% CI, 0.91-1.20).
In five studies stratifying patients for severity of psoriasis, three studies demonstrated increased trends toward suicide ideation and attempts than non-psoriatic controls.
“These findings suggest a need for providers to inquire about suicidality in patients with psoriasis,” the researchers concluded. “Caring for patients with psoriasis and their
mental health needs may require a concerted effort among dermatologists and other health care providers.” – by Rob Volansky
: Armstrong reports being an investigator and consultant/advisor to AbbVie, Amgen, Celgene, Janssen, Lilly, Modernizing Medicine, Novartis, Regeneron and Pfizer.