Risk of Suicide and Suicidality in Patients with Moderate to Severe Psoriasis: results from the British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR).


Journal

Clinical and experimental dermatology
ISSN: 1365-2230
Titre abrégé: Clin Exp Dermatol
Pays: England
ID NLM: 7606847

Informations de publication

Date de publication:
19 Oct 2024
Historique:
received: 20 07 2024
revised: 18 09 2024
accepted: 18 10 2024
medline: 19 10 2024
pubmed: 19 10 2024
entrez: 19 10 2024
Statut: aheadofprint

Résumé

Psoriasis is associated with poor mental health and reduced quality of life. Although the high risk for depression in patients with psoriasis is well-established, their suicidality risk is uncertain. Previous studies provide contrasting results and have not included patients with clinically-confirmed severe disease. Our aim was to determine risk of suicide among patients with moderate to severe psoriasis compared with the general population, and investigate if psychiatric comorbidity or history of suicidality increases future suicidality risk in psoriasis. We further estimated the incidence of suicidal and self-injurious behaviours in patients. Analysis was performed using the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR). As controls, general population mortality and suicide data were used. There were 9 suicides in BADBIR. The incidence rate of suicide was 12.5 per 100,000 person-years (95% CI 6.53, 24.11) in BADBIR versus 11.0 per 100,000 person-years (95% CI 10.7, 11.3) in the general population in England and Wales. Among patients, psychiatric comorbidity or past suicidality was associated with higher risk for suicidal ideation, suicide attempts and self-injurious behaviours. Suicide rates among patients with moderate to severe psoriasis were not significantly higher compared with the general population. Suicide is a rare event and our results are limited by the uncertainty in the estimate reliability. However, considering the high depression prevalence in psoriasis, our findings support the need for prompt assessment of patients for psychiatric comorbidities and suicidality history. Further research is required on suicidal behaviours and the role of psoriasis severity.

Sections du résumé

BACKGROUND BACKGROUND
Psoriasis is associated with poor mental health and reduced quality of life. Although the high risk for depression in patients with psoriasis is well-established, their suicidality risk is uncertain. Previous studies provide contrasting results and have not included patients with clinically-confirmed severe disease.
OBJECTIVES OBJECTIVE
Our aim was to determine risk of suicide among patients with moderate to severe psoriasis compared with the general population, and investigate if psychiatric comorbidity or history of suicidality increases future suicidality risk in psoriasis. We further estimated the incidence of suicidal and self-injurious behaviours in patients.
METHODS METHODS
Analysis was performed using the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR). As controls, general population mortality and suicide data were used.
RESULTS RESULTS
There were 9 suicides in BADBIR. The incidence rate of suicide was 12.5 per 100,000 person-years (95% CI 6.53, 24.11) in BADBIR versus 11.0 per 100,000 person-years (95% CI 10.7, 11.3) in the general population in England and Wales. Among patients, psychiatric comorbidity or past suicidality was associated with higher risk for suicidal ideation, suicide attempts and self-injurious behaviours.
CONCLUSIONS CONCLUSIONS
Suicide rates among patients with moderate to severe psoriasis were not significantly higher compared with the general population. Suicide is a rare event and our results are limited by the uncertainty in the estimate reliability. However, considering the high depression prevalence in psoriasis, our findings support the need for prompt assessment of patients for psychiatric comorbidities and suicidality history. Further research is required on suicidal behaviours and the role of psoriasis severity.

Identifiants

pubmed: 39425683
pii: 7828068
doi: 10.1093/ced/llae449
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists.

Auteurs

Kerry Williams (K)

Division of Musculoskeletal and Dermatological Sciences, NIHR Manchester Biomedical Research Centre, The University of Manchester, Manchester, UK.

Georgia Lada (G)

Dermatology Centre, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Division of Musculoskeletal & Dermatological Sciences, The University of Manchester, Manchester, UK.
Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.

Nick J Reynolds (NJ)

Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
Department of Dermatology and NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.

Kathleen Mcelhone (K)

Division of Musculoskeletal and Dermatological Sciences, NIHR Manchester Biomedical Research Centre, The University of Manchester, Manchester, UK.

Ian Evans (I)

Division of Musculoskeletal and Dermatological Sciences, NIHR Manchester Biomedical Research Centre, The University of Manchester, Manchester, UK.

Richard B Warren (RB)

Dermatology Centre, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Division of Musculoskeletal & Dermatological Sciences, The University of Manchester, Manchester, UK.
NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.

Shernaz Walton (S)

Hull University Teaching Hospitals NHS Trust, Hull, UK.

Olivia Hughes (O)

School of Psychology, Cardiff University, Cardiff, Wales, UK.

Anthony Bewley (A)

Barts Health NHS Trust, London, UK.
Queen Mary School of Medicine, University of London, London, UK.

Kayleigh Mason (K)

Primary Care Centre Versus Arthritis, School of Medicine, Keele University, UK.

C Elise Kleyn (CE)

Dermatology Centre, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Division of Musculoskeletal & Dermatological Sciences, The University of Manchester, Manchester, UK.

Classifications MeSH