Psychiatric morbidity and suicidal behaviour in psoriasis

Psoriasis is a long-term skin disorder that currently does not have a cure. Many people with psoriasis also suffer from social or emotional problems, called psychosocial comorbidities. Suggested explanations for mental illness in people with psoriasis include the considerable impact that psoriasis has on people's quality of life, mainly related to how their skin looks and how this impacts on their lives. It is thought that the psychological burden in people with psoriasis may lead to elevated risk of self-harm and suicide. This study, from the UK, examined this theory by comparing medical data from 56,961 people with psoriasis and 876,919 without. This data showed higher prevalence of alcohol misuse, bipolar disorder, depression, anxiety disorders, self-harm, and psychotropic drug (for mental health) prescription in people with psoriasis. However, while there was a 15% increase in self-harm risk in the psoriasis group versus the general population, the overall risk of suicide in people with psoriasis was 40% lower compared to peers without the condition. The risk of suicide varied according to age: it was 60% lower among individuals with psoriasis diagnosed at age 40 or over, compared to people without the disease of the same age group, whereas if the diagnosis occurred prior to age 40 years there was no difference in risk between the two groups. Healthcare professionals caring for patients with psoriasis should continue to monitor and tackle effectively the psychological needs of these individuals.