title: Risks of developing psychiatric disorders in pediatric patients with psoriasis.
abstract: BACKGROUND
  Symptoms of psoriasis can be embarrassing and distressing, and may increase risk of developing psychiatric disorders in young people.
  
  
  OBJECTIVE
  We sought to compare incidences of psychiatric disorders between pediatric patients with psoriasis and psoriasis-free control subjects.
  
  
  METHODS
  Patients (<18 years) with continuous health plan enrollment 6 months before and after first psoriasis diagnosis (index date) were selected (Thomson Reuters MarketScan database, 2000-2006 [Thomson Reuters, New York, NY]). Patients with psoriasis (N = 7404) were matched 1:5 on age and sex to psoriasis-free control subjects (N = 37,020). Patients were followed from index date to first diagnosis of a psychiatric disorder (ie, alcohol/drug abuse, depression, anxiety disorder, bipolar disorder, suicidal ideation, eating disorder), end of data availability, or disenrollment. Patients with psychiatric diagnoses or psychotropic medication use before the index date were excluded. Cox proportional hazard models controlling for age, sex, and comorbidities were used to estimate the effect of psoriasis on risks of developing psychiatric disorders.
  
  
  RESULTS
  Patients with psoriasis were significantly more at risk of developing psychiatric disorders versus control subjects (5.13% vs 4.07%; P = .0001; hazard ratio = 1.25; P = .0001), especially depression (3.01% vs 2.42%; P = .0036; hazard ratio = 1.25; P = .0053) and anxiety (1.81% vs 1.35%; P = .0048; hazard ratio = 1.32; P = .0045).
  
  
  CONCLUSIONS
  Retrospective, observational studies of medical claims data are typically limited by overall quality and completeness of data and accuracy of coding for diagnoses and procedures.
  
  
  CONCLUSIONS
  Pediatric patients with psoriasis had an increased risk of developing psychiatric disorders, including depression and anxiety, compared with psoriasis-free control subjects.
authors.affiliation: Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. harvardskinstudies@partners.org
authors.forename: Alexa B
authors.initials: AB
authors.lastname: Kimball
authors.forename: Eric Q
authors.initials: EQ
authors.lastname: Wu
authors.forename: Annie
authors.initials: A
authors.lastname: Guérin
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Yu
authors.forename: Magda
authors.initials: M
authors.lastname: Tsaneva
authors.forename: Shiraz R
authors.initials: SR
authors.lastname: Gupta
authors.forename: Yanjun
authors.initials: Y
authors.lastname: Bao
authors.forename: Parvez M
authors.initials: PM
authors.lastname: Mulani
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011565:Psoriasis / Q000453:epidemiology* / Q000523:psychology*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D059020:Suicidal Ideation; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs