Clinical Edge

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Association Between Psoriasis and Suicide Ideation

J Am Acad Dermatol; 2017 Sep; Singh, et al

Patients with psoriasis have a significantly higher likelihood of suicidal ideation, suicide attempts, and completed suicides, a recent study found. Applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, researchers systematically searched the literature databases, seeking material published between 1946 and 2017. They identified 18 studies with a total of 1,767,583 participants, of whom 330,207 had psoriasis. They found:

  • On the basis of random effects modeling, the pooled odds ratio (OR) for suicidal ideation among patients with psoriasis was 2.05.
  • Patients with psoriasis were more likely to exhibit suicidal behaviors (combined attempted and completed suicides) with a pooled OR of 1.26.
  • Subgroup analysis showed that patients with psoriasis were more likely to attempt suicides (OR, 1.32) and complete suicide (OR, 1.20) than those without psoriasis.
  • More severe psoriasis and younger age were associated with greater likelihood of suicidality.

Citation:

Singh S, Taylor C, Kornmehl H, Armstrong AW. Psoriasis and suicidality: A systematic review and meta-analysis. J Am Acad Dermatol. 2017;77(3):425-440.e2. doi:10.1016/j.jaad.2017.05.019.

Commentary:

This systematic review and meta-analysis demonstrates that patients with psoriasis have a significantly higher likelihood of experiencing suicidal ideation, suicide attempts, and completed suicides. Patients with greater disease severity and younger patients are especially at higher risk for suicidality. When treating a patient with psoriasis, irrespective of severity, quality of life issues and mental health impact should be addressed. The provider should be able to recognize if the patient is at risk of suicide, especially with younger patients with higher severity.—Paul S. Yamauchi, MD, PhD

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