Association of Psoriasis with Psychiatric Hospitalization in United States Children and Adults

Abstract

Background: Psoriasis is associated with psychosocial distress. Little is known about the relationship between psoriasis and mental health (MH) emergencies. Objective: To examine the associations of psoriasis and MH hospitalizations in the USA. Methods: Data from the 2002–2012 National Inpatient Sample were analyzed, including an approximately 20% sample of all US hospitalizations (n = 87,053,155 children and adults). Results: Hospitalization for MH disorders occurred more commonly in those with psoriasis compared to those without psoriasis (4.04 vs. 2.21%). In multivariable logistic regression models, psoriasis was associated with higher odds of admission for any MH disorder overall (adjusted odds ratio [95% confidence interval]: 2.32 [2.24–2.41]), as well as 9 of the 15 MH-specific disorders examined. Associated MH disorders included: anxiety, schizophrenia, personality disorder, depression, substance use disorders, history of MH disorder, alcohol-related disorders, adjustment disorders, and cognitive disorders. Children with versus those without psoriasis were also more likely to have a primary hospitalization for any MH disorder (2.82 [2.24–3.56]). Psoriasis inpatients were also more likely to have a primary hospitalization for any MH disorder compared to those with alopecia areata (1.99 [1.45–2.74]) or hidradenitis suppurativa (3.97 [3.49–4.52]). Psoriasis patients hospitalized with any MH disorder had higher mean [95% confidence interval] cost of inpatient care (USD 11,004 [10,846–11,241] vs. 9,547 [8,730–10,364]; p < 0.0001) compared to those without psoriasis, with USD 1,610,860 excess costs annually, with the majority of the costs coming from depression and mood disorders. Conclusions: Children and adults with psoriasis had increased hospitalization for multiple MH disorders, which were associated with a considerable financial burden.

Health, educational and employment outcomes among children treated for a skin disorder: Scotland-wide retrospective record linkage cohort study of 766,244 children

“…Previous studies investigating health outcomes of children with skin disorders are limited in number. Whilst adults with skin disorders reportedly suffer from increased mortality [35,36], studies reporting hospitalisation and mortality among children and adolescents are rare [37,38]. However, our finding of increased risk of death does concur with a previous study reporting greater premature mortality among children with psoriasis [38].…”

“…However wider comorbidities exist which we could not adjust for. For example, childhood eczema has also been associated with comorbid allergic rhinitis, hay fever and autoimmune disorders [15][16][17] and even suicidal ideation/behaviour [32][33][34] whilst psoriasis has been associated with obesity, cardiovascular disorders, rheumatoid arthritis, and Crohn's disease [14,[19][20][21] as well as more psychiatric hospitalisations [37]. Therefore, in addition to the direct physical and mental effects associated with skin disorders, it is possible that the greater hospitalisation and mortality observed may be partly attributable to the increased physical and mental comorbidities associated with both eczema and psoriasis over and above those adjusted for in our analyses.…”

Immunological aspects of determination of an adequate biological treatment sequence for inflammatory bowel diseases: the expert board statement (St. Petersburg, May 22, 2021)

“…В регистрационном исследовании GEMINI-2 ведолизумаб показал высокую эффективность при БК в достижении как клинической, так и эндоскопической ремиссии, при этом был получен быстрый клинический ответ на терапию [14][15][16]. Подобные выводы подтверждаются и данными реальной клинической практики, преимущественно у пациентов с БК средней степени тяжести [17,18]. Схожие показатели эффективности ведолизумаба отмечены при ЯК [19,20].…”

Depressive symptoms among mothers of children with psoriasis—A case‐control study

“…This impact appears to be even more complex when the patients are children. Several studies have focused on emotional disturbances in children affected by psoriasis 1‐3 . Children with psoriasis may have as high as a 6.65‐fold greater risk of developing depression and a 9.21‐fold greater risk of having anxiety 2 .…”

“…Several studies have focused on emotional disturbances in children affected by psoriasis. [1][2][3] Children with psoriasis may have as high as a 6.65-fold greater risk of developing depression and a 9.21-fold greater risk of having anxiety. 2 On the other hand, little is known about the presence of psychiatric disorders among their caregivers.…”