title: Pemphigus and depression comorbidity: a case control study.
abstract: BACKGROUND
  While quality of life can be significantly affected in pemphigus patients, few studies have systematically investigated the co-morbidity of psychiatric disorders in these patients.
  
  
  OBJECTIVE
  To assess the association between pemphigus and depression comorbidity, using the computerized medical database of Israel's largest health maintenance organization.
  
  
  METHODS
  In a case-control study, co-morbidities of adult pemphigus patients retrieved from the database of a large healthcare organization from 1998 to 2010 were compared with age- and gender-matched controls from the same database. The main outcome measure was the prevalence of co-morbid psychiatric disorders (anxiety, psychosis, schizophrenia and depression) in pemphigus patients and controls. The study included 255 pemphigus patients (157 women (62%) and 98 (38%) men) and 509 controls (313 women (62%) and 196 (38%) men) aged 20 years and older (a ratio of 3:2 in both groups). Mean age was 63.5 ± 15.7 years in the pemphigus group and 63.2 ± 15.7 years in the control group.
  
  
  RESULTS
  Depression was the only psychiatric disorder significantly increased among pemphigus patients compared with controls. Alcohol abuse and smoking did not differ between groups. Depression was over-represented in a large population of pemphigus patients, indicating the disorder as a possible significant co-morbidity. After controlling for confounders including age, gender, and duration of corticosteroid therapy, the association with depression persisted (OR = 1.19, 95% CI: 1.12-1.27), p<0.001).
  
  
  CONCLUSIONS
  The increased prevalence of depressive morbidity, especially in the presence of commonly prescribed corticosteroid treatment, emphasizes the need for psychiatric assessment and intervention in these patients.
authors.affiliation: Dermatology Service, Barzilai University Medical Center, Ashkelon 78278 Israel, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Yonit
authors.initials: Y
authors.lastname: Wohl
authors.affiliation: Pediatric Dermatology Unit, Department of Dermatology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 64239, Israel.
authors.forename: Jacob
authors.initials: J
authors.lastname: Mashiah
authors.affiliation: Pediatric Dermatology Unit, Department of Dermatology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 64239, Israel.
authors.forename: Ana
authors.initials: A
authors.lastname: Kutz
authors.affiliation: Department of Dermatology; Centre national de référence des maladies génétiques à expression cutanée (Magec), hôpital universitaire Necker-Enfants Malades; APHP; université Paris Descartes - Sorbonne Paris Cité; Institut Imagine, Paris, France.
authors.forename: Smail
authors.initials: S
authors.lastname: Hadj-Rabia
authors.affiliation: Siaal Research Center for Family Medicine and Primary Care, Ben -Gurion University of the Negev, Beer-Sheva, Israel, Research and Health Planning Department, Clalit Health Services, Tel Aviv 6209804 Israel.
authors.forename: Arnon D
authors.initials: AD
authors.lastname: Cohen
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015897:Comorbidity / Q000639:trends; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D015995:Prevalence; D011594:Psychometrics / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D005938:Glucocorticoids
keywords: corticoid therapy; depression; pemphigus