Affiliation:
1. Department of Dermatology Stavanger University Hospital Stavanger Norway
2. Faculty of Health Sciences University of Stavanger Stavanger Norway
3. Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders Innlandet Hospital Trust Brumunddal Norway
4. Department of Nursing and Health Promotion Oslo Metropolitan University Oslo Norway
5. Division of Mental Health and Addiction Vestfold Hospital Trust Tønsberg Norway
6. Department of Dermatology and Venereology Skåne University Hospital University of Lund Malmö Sweden
7. Faculty of Social and Health Sciences Inland Norway University of Applied Sciences Elverum Norway
Abstract
AbstractBackgroundThe existing association between skin disease and psychiatric comorbidity has gained attention during the last decades. Stress and mental illness can directly or indirectly affect skin disease, while dermatological conditions, known to impair life quality and mental well‐being, can promote psychiatric conditions.ObjectivesThe aim of this study was to assess the risk of developing psychiatric disease among adult dermatological patients over a period of time. The secondary objective was to see which psychiatric disorders developed most commonly, and which skin diseases posed the greatest risk for later mental health issues.MethodsAdult dermatological patients were followed for 9 years (2008–2016) using the Norwegian Patient Registry, for both outpatient and inpatient specialist healthcare services. Dermatological patients were identified during the first 2 years and were then followed for psychiatric comorbidity prospectively for the next 7 years.Cox regression models were applied to estimate the risks of psychiatric disorders among patients with skin diseases. Estimates were adjusted for age and gender differences. Hazard risk ratios (HR) with 95% CI are reported.ResultsDermatological patients developed depressive disorders most frequently (4.1% vs. 2.3% in non‐dermatological participants), followed by anxiety disorders (3.3% vs. 1.8%), and adjustment disorders (2.6% vs. 1.5%). Developing depressive disorders showed the highest HR among dermatological patients, HR (95% CI) = 2.5 (2.4–2.5), followed by disorders related to alcohol use, HR (95% CI) = 2.2 (2.1–2.5), and anxiety disorders, HR (95% CI) = 2.1 (2.1–2.2). Papulosquamous disorders were the skin conditions with the highest HR for developing a mental health condition, with depressive disorder having HR (95% CI) = 2.6 (2.5–2.9); anxiety disorders at HR (95% CI) = 2.9 (2.7–3.1); and disorders related to alcohol use at HR (95% CI) = 3.2 (2.8–3.6).ConclusionsThe study demonstrates that having a skin disease doubles to triples the risk of developing a psychiatric illness within 7 years, especially depression, anxiety, and alcohol use compared with the general population.
Funder
Universitetet i Stavanger
Helse Sør-Øst RHF