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Risk of depression in women with psoriasis: a cohort study
Author(s) -
Dommasch E.D.,
Li T.,
Okereke O.I.,
Li Y.,
Qureshi A.A.,
Cho E.
Publication year - 2015
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.14032
Subject(s) - psoriasis , medicine , depression (economics) , hazard ratio , prospective cohort study , body mass index , odds ratio , cohort study , psoriatic arthritis , cohort , confounding , relative risk , proportional hazards model , concomitant , confidence interval , physical therapy , dermatology , economics , macroeconomics
Summary Background Psoriasis is a common, chronic and inflammatory disease of the skin, which has been associated with depression in cross‐sectional studies with limited adjustment for confounders. Objectives In this prospective cohort study, we investigated the risk of incident depression among individuals with psoriasis and psoriatic arthritis (PsA). Methods We included 50 750 US female nurses from the Nurses' Health Study who were free of depression at baseline in 2000. Those participants who had ever self‐reported clinician‐diagnosed depression or regular use of antidepressants, or had a Mental Health Inventory score of ≤ 52 were excluded. In 2008, we retrospectively asked participants if they had ever received a physician's diagnosis of psoriasis or PsA. We defined depression as self‐report of clinician‐diagnosed depression or regular use of antidepressant medication. Time‐dependent Cox proportional hazard models were used to estimate age and multivariate‐adjusted relative risks ( RR s) of clinical depression. Results After adjusting for covariates including body mass index, physical activity, smoking and the presence of major chronic conditions, the multivariate‐adjusted RR s of clinical depression were 1·29 [95% confidence interval ( CI ) 1·10–1·52] for women with psoriasis and 1·52 (95% CI 1·06–2·19) for women with psoriasis and concomitant PsA, compared with women without psoriasis. Conclusions We found an increased risk of depression in US women with psoriasis compared with those without psoriasis. This risk was higher in those who reported concomitant PsA. Future studies are needed to confirm these findings in other populations and to identify pathophysiological mechanisms linking psoriasis to depression.