Citation

Matterne U, Baumeister SE, Apfelbacher C. Br. J. Dermatol. 2019; ePub(ePub): ePub.

Affiliation

Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Germany.

Copyright

(Copyright © 2019, John Wiley and Sons)

DOI

10.1111/bjd.18108

PMID

31074832

Abstract

AIM: Chi et al. (Am J Clin Dermatol; 31(5): 798-807) and Singh et al (J Am Acad Dermatol; 77(3): 425-440.e2) each conducted a systematic review and meta-analysis of observational studies examining the relationship between suicidality and psoriasis. SETTING AND DESIGN: Chi et al. included only cohort studies while Singh et al. included cohort, cross-sectional and case-control studies. PRIMARY EXPOSURE AND OUTCOME: The primary outcome, suicidality was assessed in people with psoriasis (exposure) and people with no psoriasis. Analyses were separated for suicidal ideation and behaviour.

RESULTS: Chi et al. included five population-based cohort studies that were considered to be of high quality according to the Newcastle-Ottawa-Scale (NOS). They found no significant increase in the risk of suicide (risk ratio [RR] 1.13; 95% confidence interval [CI] 0.87-1.46), suicide attempt (RR 1.25; 95% CI 0.89-1.75), or suicidality (RR 1.26; 95% CI 0.97-1.64) among people with psoriasis. Singh et al. included 18 studies that were rated to be of medium to high quality according to NOS. They found a pooled odds ratio (OR) for suicidal ideation among patients with psoriasis of 2.05 (95% CI, 1.54-2.74). For suicidal behaviours (combined attempted and completed suicides) a pooled OR of 1.26 (95% CI, 1.13-1.40) was obtained, suggesting a higher risk of these behaviours in people with psoriasis. Subgroup analysis showed that patients with psoriasis were more likely to attempt suicides (OR, 1.32; 95% CI, 1.14-1.54) and complete suicide (OR, 1.20; 95% CI, 1.04-1.39) than those without psoriasis.

CONCLUSION: Singh et al. concluded that patients with psoriasis have a significantly higher risk of suicidal ideation, suicide attempts, and completed suicides, while Chi et al concluded that the available limited, very low-quality evidence does not support the notion of an association between psoriasis on the one hand, and suicide, suicidal ideation and attempts on the other. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

Language: en