Risk of first-time and recurrent depression in patients with psoriasis: a population-based cohort study
Risk of first-time and recurrent depression in patients with psoriasis: a population-based cohort study
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DOI：
10.1111/bjd.17208
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发表时间：
2019-01-01
影响因子：
10.3
通讯作者：
Skov, L.
中科院分区：
文献类型：
--
作者：
Egeberg, A.;Thyssen, J. . P.;Skov, L.
背景 银屑病会损害生活质量，但尚不清楚银屑病是否也是抑郁症的独立危险因素。目的 评估银屑病患者新发和复发抑郁症的发生率和风险。方法 我们使用丹麦行政登记册的个人级别链接。 1997年1月1日至2016年12月31日期间年龄≥18岁的银屑病患者与无银屑病的个体以1:1的比例进行匹配。计算发病率并调整通过 Cox 回归估计的危险比 (HR)。结果 共有 247 755 名银屑病患者：220 721 名接受局部用药（轻度银屑病）治疗，24 771 名接受全身非生物制剂治疗（中度银屑病），2263 名接受生物治疗（重度银屑病）。还分析了相同数量的无银屑病的匹配参考对象。在长达 20 年的随访期间，45 641 名银屑病患者和 36 299 名患者出现了抑郁症。在调整后的模型中，轻度、中度和重度银屑病抑郁症的 HR（95% 置信区间）分别为 1.19（1.17-1.20）、1.19（1.15-1.23）和 1.50（1.23-1.84）。 40-50 岁的严重银屑病患者风险最高。并发炎症性肠病（但不是银屑病关节炎）与抑郁症风险增加相关。既往患有抑郁症的患者抑郁症的发生率明显更高。结论 银屑病与抑郁症风险独立相关。这些结果可能有助于临床医生识别特别高风险的个体。
Background Psoriasis impairs quality of life, but it is unknown whether psoriasis is also an independent risk factor for depression. Objectives To evaluate the incidence and risk of new and recurrent depression in patients with psoriasis. Methods We used individual-level linkage of Danish administrative registers. Patients with psoriasis aged >= 18 years between 1 January 1997 and 31 December 2016 were matched 1 : 1 with individuals without psoriasis. Incidence rates were calculated and adjusted hazard ratios (HRs) estimated by Cox regression. Results There were 247 755 patients with psoriasis: 220 721 were treated with topicals (mild psoriasis), 24 771 with systemic nonbiologics (moderate psoriasis) and 2263 with biological therapy (severe psoriasis). The same number of matched referents without psoriasis were also analysed. During a maximum 20 years of follow-up, 45 641 patients with psoriasis and 36 299 referents developed depression. In adjusted models, the HRs (95% confidence interval) of depression were 1.19 (1.17-1.20), 1.19 (1.15-1.23) and 1.50 (1.23-1.84) for mild, moderate and severe psoriasis, respectively. The highest risk was observed among patients with severe psoriasis aged 40-50 years. Concurrent inflammatory bowel disease, but not psoriatic arthritis, was associated with increased risk of depression. The incidence of depression was markedly higher among patients with previous depression. Conclusions Psoriasis was independently associated with risk of depression. These results may help clinicians identify particularly high-risk individuals.