The risk of depression, suicidal ideation and suicide attempt in patients with psoriasis, psoriatic arthritis or ankylosing spondylitis

J Eur Acad Dermatol Venereol. 2017 Jul;31(7):1168-1175. doi: 10.1111/jdv.14175. Epub 2017 Apr 21.


Background: Sparse information is available concerning mental health issues in psoriasis, psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients.

Objective: To estimate risk of depression, suicidal ideation and suicide attempt in patients with psoriasis, PsA and AS, respectively, compared with the general population.

Methods: This population-based cohort study analysed 36 214 psoriasis patients, 5138 PsA patients and 1878 AS patients who were frequency-matched with a general population cohort. Annual incidence rate of depression, suicidal ideation and suicide attempt was calculated separately for psoriasis, PsA and AS.

Results: There was an increased risk of depression in the three cohorts; adjusted IRR: psoriasis, 1.14 (95% CI, 1.11, 1.17); PsA, 1.22 (95% CI, 1.16, 1.29); AS, 1.34 (95% CI, 1.23, 1.47). There was no significantly increased risk for suicidal ideations or suicide attempt among psoriasis, PsA or AS patients.

Limitations: Patients were not excluded if previously diagnosed with depression, suicidal ideation or suicide attempt. Suicide attempt and completed suicide analyses were not adjusted for presence of depression. Use of systemic psoriasis treatment to measure severe psoriasis could lead to psoriasis severity misclassification.

Conclusion: The risk of depression, but not suicidal ideation or suicide attempt, was significantly increased in patients with psoriasis, PsA and AS.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arthritis, Psoriatic / complications
  • Arthritis, Psoriatic / psychology*
  • Cohort Studies
  • Depression / complications*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Psoriasis / complications
  • Psoriasis / psychology*
  • Spondylitis, Ankylosing / complications
  • Spondylitis, Ankylosing / psychology*
  • Suicidal Ideation*
  • Suicide, Attempted*
  • Young Adult