Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
J Am Acad Dermatol. 2012 Oct;67(4):651-7.e1-2. doi: 10.1016/j.jaad.2011.11.948. Epub 2012 Jan 13.
Symptoms of psoriasis can be embarrassing and distressing, and may increase risk of developing psychiatric disorders in young people.
We sought to compare incidences of psychiatric disorders between pediatric patients with psoriasis and psoriasis-free control subjects.
Patients (<18 years) with continuous health plan enrollment 6 months before and after first psoriasis diagnosis (index date) were selected (Thomson Reuters MarketScan database, 2000-2006 [Thomson Reuters, New York, NY]). Patients with psoriasis (N = 7404) were matched 1:5 on age and sex to psoriasis-free control subjects (N = 37,020). Patients were followed from index date to first diagnosis of a psychiatric disorder (ie, alcohol/drug abuse, depression, anxiety disorder, bipolar disorder, suicidal ideation, eating disorder), end of data availability, or disenrollment. Patients with psychiatric diagnoses or psychotropic medication use before the index date were excluded. Cox proportional hazard models controlling for age, sex, and comorbidities were used to estimate the effect of psoriasis on risks of developing psychiatric disorders.
Patients with psoriasis were significantly more at risk of developing psychiatric disorders versus control subjects (5.13% vs 4.07%; P = .0001; hazard ratio = 1.25; P = .0001), especially depression (3.01% vs 2.42%; P = .0036; hazard ratio = 1.25; P = .0053) and anxiety (1.81% vs 1.35%; P = .0048; hazard ratio = 1.32; P = .0045).
Retrospective, observational studies of medical claims data are typically limited by overall quality and completeness of data and accuracy of coding for diagnoses and procedures.
Pediatric patients with psoriasis had an increased risk of developing psychiatric disorders, including depression and anxiety, compared with psoriasis-free control subjects.
银屑病的症状可能令人尴尬和痛苦，并可能增加年轻人患精神障碍的风险。
我们旨在比较患有银屑病的儿科患者和无银屑病对照者之间精神障碍的发生率。
选择了在首次银屑病诊断（索引日期）前 6 个月有连续健康计划参保的患者（Thomson Reuters MarketScan 数据库，2000-2006[Thomson Reuters，纽约，NY]）。根据年龄和性别，将银屑病患者（N=7404）与 37020 名无银屑病对照者进行 1:5 匹配。从索引日期开始，对患者进行随访，直至首次诊断出精神障碍（即酒精/药物滥用、抑郁、焦虑障碍、双相情感障碍、自杀意念、进食障碍）、数据可用期结束或退出。在索引日期之前患有精神疾病诊断或使用精神药物的患者被排除在外。使用 Cox 比例风险模型，控制年龄、性别和合并症，以评估银屑病对发生精神障碍风险的影响。
与对照者相比，银屑病患者发生精神障碍的风险显著更高（5.13%比 4.07%；P<.0001；风险比=1.25；P<.0001），尤其是抑郁（3.01%比 2.42%；P=.0036；风险比=1.25；P=.0053）和焦虑（1.81%比 1.35%；P=.0048；风险比=1.32；P=.0045）。
医疗索赔数据的回顾性观察性研究通常受到数据整体质量和完整性以及诊断和程序编码准确性的限制。
与无银屑病对照者相比，患有银屑病的儿科患者发生精神障碍（包括抑郁和焦虑）的风险增加。
