title: Incidence rates of suicidal behaviors and treated depression in patients with and without psoriatic arthritis using the Clinical Practice Research Datalink.
abstract: OBJECTIVE
  To estimate rates of suicidal behaviors and treated depression in patients with psoriatic arthritis (PsA) in comparison to non-PsA patients.
  
  
  METHODS
  Using the Clinical Practice Research Datalink, we conducted a cohort study of patients with PsA compared to non-PsA patients. Patients with codes for suicidal behaviors (ideation, attempts, and suicide) and treated depression (diagnosis plus anti-depressant prescription) recorded during follow-up were identified as cases. We estimated incidence rates (IRs) and incidence rate ratios (IRRs) with 95% confidence intervals (CIs) for each outcome and stratified results in the PsA cohort by receipt of systemic PsA drugs.
  
  
  RESULTS
  The rates of suicide ideation, attempt, and suicide were similar for PsA and non-PsA patients [IRR = 0.99 (95%CI: 0.67-1.47), IRR = 1.07 (95%CI: 0.86-1.34), and 0.34 (95%CI: 0.05-2.48), respectively] and rates of suicidal behaviors were slightly higher among PsA patients who received PsA drugs compared to those who did not. PsA patients had slightly higher rate of treated depression compared to non-PsA patients [IRR = 1.38 (95%CI: 1.27-1.49)] and were significantly higher in PsA patients who received drugs [IRR = 1.59 (95%CI: 1.35-1.86)].
  
  
  CONCLUSIONS
  Rate of depression was higher in patients with PsA compared to non-PsA patients. The rate of suicidal behaviors was similar between the two cohorts.
authors.affiliation: a Boston Collaborative Drug Surveillance Program and Boston University School of Public Health , Lexington , MA , USA and.
authors.forename: Katrina Wilcox
authors.initials: KW
authors.lastname: Hagberg
authors.affiliation: a Boston Collaborative Drug Surveillance Program and Boston University School of Public Health , Lexington , MA , USA and.
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.affiliation: b Celgene Corporation , Berkeley Heights , NJ , USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Peng
authors.affiliation: b Celgene Corporation , Berkeley Heights , NJ , USA.
authors.forename: Kamal
authors.initials: K
authors.lastname: Shah
authors.affiliation: b Celgene Corporation , Berkeley Heights , NJ , USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Paris
authors.affiliation: a Boston Collaborative Drug Surveillance Program and Boston University School of Public Health , Lexington , MA , USA and.
authors.forename: Susan
authors.initials: S
authors.lastname: Jick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents
keywords: Depression; Psoriatic arthritis; Suicidal ideation; Suicide; Suicide attempt