title: Increased prevalence of psychiatric disorders and health care-associated costs among patients with moderate-to-severe psoriasis.
abstract: OBJECTIVE
  To characterize the prevalence of psychiatric disorders in patients with moderate-to-severe psoriasis and compare health care costs between patients with and without psychiatric comorbidities.
  
  
  METHODS
  In a retrospective, matched case-control study, data for services from nearly 75 health care plans in the United States (U.S.) were collected from PharMetrics Patient Centric Database using International Classification of Diseases, Ninth Revision Clinical Modification codes, identifying a total of 39,855 adults with moderate-to-severe psoriasis (n=7,971) and without (controls; n=31,884). Patients with psoriasis had at least one psoriasis health care claim and received at least one medical/prescription treatment claim within two consecutive years. Psychiatric comorbidities and treatments among patients and controls were determined by claims. Annual inpatient, outpatient, emergency room, and prescription costs for those with and without psoriasis and those with and without psychiatric disorders were compared.
  
  
  RESULTS
  Patients had significantly higher prevalence of anxiety (6.9% versus 4.4%), depression (9.2% versus 5.3%), bipolar disorder (1.1% versus 0.5%), or delirium (0.3% versus 0.1%; P is less than 0.05) than controls (others P is less than 0.0001). Significantly higher proportions of patients with psoriasis received antidepressants (6.1% versus 0.9%), anxiolytics (5.0% versus 0.8%), or antipsychotics (5.9% versus 0.9%) compared with controls (each P is less than 0.0001). Total health care costs for patients with psoriasis (US $11, 369.47) were significantly higher than for controls ($3,427.60; P is less than 0.001). Psoriasis patients with psychiatric disorders had significantly higher health care costs ($17,637.66) than those without psychiatric disorders ($10,362.80; P is less than 0.001).
  
  
  CONCLUSIONS
  The prevalence of psychiatric disorders is higher in patients with moderate-to-severe psoriasis than in controls. Annual health care costs are higher in psoriasis patients with psychiatric disorders than in those without psychiatric disorders.
authors.affiliation: Janssen Global Services, LLC, Malvern, PA, USA. Chan3@its.jnj.com
authors.forename: Chenglong
authors.initials: C
authors.lastname: Han
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Lofland
authors.forename: Ning
authors.initials: N
authors.lastname: Zhao
authors.forename: Brad
authors.initials: B
authors.lastname: Schenkel
mesh_terms: D016022:Case-Control Studies; D015897:Comorbidity; D017281:Cost of Illness; D016208:Databases, Factual; D018450:Disease Progression; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology* / Q000523:psychology; D011565:Psoriasis / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology