title: Depression and the risk of psoriasis in US women.
abstract: BACKGROUND
  Depression is a common mental health condition that has been associated with psoriasis. In the absence of prospective data, it remains unclear whether depression precedes psoriasis as a risk factor.
  
  
  OBJECTIVE
  To examine the association between depression and the risk of new-onset psoriasis.
  
  
  METHODS
  A prospective cohort of 86 880 US female nurses, The Nurses' Health Study II, was followed up from 1993 to 2005. Participants reported anti-depressant use and completed the Mental Health Index (MHI), a subscale of the Short-Form 36 in 1993. The MHI assessed for depression and scores was categorized into four strata: 0-52, 53-75, 76-85 and 86-100, with lower scores associated with increasing depressive symptoms. We excluded participants with a history of psoriasis prior to 1993. A self-report of incident physician-diagnosed psoriasis constituted the main outcome measure. For a sensitivity analysis, we had a subset of confirmed psoriasis cases.
  
  
  RESULTS
  Depression was associated with an increased risk of incident psoriasis. Compared to women in the non-depressed group (MHI 86-100), women who reported either having high depressive symptomatology (MHI scores < 52) or who were on anti-depressants had a multivariate relative risk (RR) of 1.59 for developing subsequent psoriasis (95% confidence interval [CI], 1.21-2.08). These associations became stronger among confirmed psoriasis cases.
  
  
  CONCLUSIONS
  We found that depression was independently associated with an increased risk of psoriasis in this population of US women.
authors.affiliation: Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: P L
authors.initials: PL
authors.lastname: Dominguez
authors.forename: J
authors.initials: J
authors.lastname: Han
authors.forename: T
authors.initials: T
authors.lastname: Li
authors.forename: A
authors.initials: A
authors.lastname: Ascherio
authors.forename: A A
authors.initials: AA
authors.lastname: Qureshi
mesh_terms: D000328:Adult; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D011446:Prospective Studies; D011565:Psoriasis / Q000453:epidemiology* / Q000209:etiology*; D012307:Risk Factors; D014481:United States