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Risk of suicide and suicidality in patients with moderate to severe psoriasis: Results from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR)

Lookup NU author(s): Professor Nick ReynoldsORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2024 The Author(s). Published by Oxford University Press on behalf of British Association of Dermatologists.Background: Psoriasis is associated with poor mental health and reduced quality of life. Although the high risk for depression in patients with psoriasis is well established, the suicidality risk among these patients is uncertain. Previous studies provide contrasting results and have not included patients with clinically confirmed severe disease. Objectives: To determine the risk of suicide among patients with moderate to severe psoriasis and to compare it with that of the general population, and to investigate if psychiatric comorbidity or history of suicidality increases future suicidality risk in psoriasis. We further estimated the incidence of suicidal and self-injurious behaviours in patients. Methods: Analysis was performed using the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR). General population mortality and suicide data were used as controls. Results: There were nine suicides in BADBIR. The incidence rate of suicide was 12.5 per 100 000 person-years [95% confidence interval (CI) 6.53-24.11] in BADBIR vs. 11.0 per 100 000 person-years (95% CI 10.7-11.3) in the general population in England and Wales. Among patients, psychiatric comorbidity or past suicidality was associated with a higher risk for suicidal ideation, suicide attempts and self-injurious behaviours. Conclusions: The suicide rate among patients with moderate to severe psoriasis was not significantly higher when compared with the general population. Suicide is a rare event and our results are limited by uncertainty about the reliability of the estimate. However, considering the high depression prevalence in psoriasis, our findings support the need for prompt assessment of patients for psychiatric comorbidities and suicidality history. Further research is required on suicidal behaviours and the role of psoriasis severity.


Publication metadata

Author(s): Williams K, Lada G, Reynolds NJ, McElhone K, Evans I, Warren RB, Walton S, Hughes O, Bewley A, Mason K, Kleyn CE, BADBIR Study Group

Publication type: Article

Publication status: Published

Journal: Clinical and Experimental Dermatology

Year: 2025

Volume: 50

Issue: 4

Pages: 804-811

Print publication date: 01/04/2025

Online publication date: 21/10/2024

Acceptance date: 12/10/2024

Date deposited: 14/04/2025

ISSN (print): 0307-6938

ISSN (electronic): 1365-2230

Publisher: Oxford University Press

URL: https://doi.org/10.1093/ced/llae449

DOI: 10.1093/ced/llae449

Data Access Statement: Restrictions apply to the availability of these data for reasons of patient consent and licensing agreements; data were used under licence for this study. The authors therefore cannot make these data publicly available.

PubMed id: 39425683


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Funding

Funder referenceFunder name
British Association of Dermatologists Biologics Register Ltd (BADBRL)
NIHR Manchester Biomedical Research Centre
NIHR203308

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