title: Psychiatric and neurological disorders are associated with bullous pemphigoid - a nationwide Finnish Care Register study.
abstract: Bullous pemphigoid (BP) is an autoimmune blistering skin disease with increasing incidence. BP is associated with neurological disorders, but it has not been established, what subtypes of dementia and stroke are associated with BP, and what is the temporal relation between these diseases. Also, the association between BP and psychiatric disorders is controversial. We conducted a retrospective nationwide study, using the Finnish Care Register for Health Care diagnoses between 1987 and 2013. The study population of 4524 BP patients were compared with 66138 patients with basocellular carcinoma (BCC), neurological and psychiatric comorbid disorders were evaluated for both groups, and associations were estimated by Cox regression and logistic regression analyses. The strongest risk of developing BP was found after diagnosis of multiple sclerosis (MS) (OR=5.9, 95% CI 3.9-8.5). Among psychiatric diseases, the corresponding risk was strongest in schizophrenia (OR=2.7, 95% CI 2.0-3.5), and as a novel finding, also personality disorders (OR=2.2, 95% CI 1.3-3.3) preceded BP. In conclusion, many psychiatric disorders, especially schizophrenia, carry heightened risk for BP. Furthermore, several neurological diseases which cause central nervous system inflammation or degeneration were related to BP, and the association was strongest between MS and BP.
authors.affiliation: PEDEGO Research Unit, University of Oulu; Department of Dermatology and Medical Research Center Oulu, Oulu University Hospital, P.O. Box 20, 90029 Oulu University Hospital, Oulu, Finland.
authors.forename: Anna-Kaisa
authors.initials: AK
authors.lastname: Försti
authors.affiliation: Unit of General Practice, P.O. Box 10, 90029 Oulu University Hospital, Oulu, Finland.|Center for Life Course Epidemiology and Systems Medicine, P.O. Box 5000, 90014, University of Oulu, Oulu, Finland.
authors.forename: Jari
authors.initials: J
authors.lastname: Jokelainen
authors.affiliation: Research Unit of Clinical Neuroscience, University of Oulu; Department of Neurology and Medical Research Center Oulu, Oulu University Hospital, P.O. Box 5000, 90014, University of Oulu, Oulu, Finland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Ansakorpi
authors.affiliation: Psychoses and Forensic Psychiatry, Helsinki University Hospital, Vanha Valtatie 198, 04500, Kellokoski, Finland and Vanha Vaasa Hospital, Vierinkiventie 1, 65380 Vaasa, Finland.
authors.forename: Allan
authors.initials: A
authors.lastname: Seppänen
authors.affiliation: Research Unit of Clinical Neuroscience, University of Oulu; Department of Neurology and Medical Research Center Oulu, Oulu University Hospital, P.O. Box 5000, 90014, University of Oulu, Oulu, Finland.
authors.forename: Kari
authors.initials: K
authors.lastname: Majamaa
authors.affiliation: Center for Life Course Epidemiology and Systems Medicine, P.O. Box 5000, 90014, University of Oulu, Oulu, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Timonen
authors.affiliation: PEDEGO Research Unit, University of Oulu; Department of Dermatology and Medical Research Center Oulu, Oulu University Hospital, P.O. Box 20, 90029 Oulu University Hospital, Oulu, Finland.
authors.forename: Kaisa
authors.initials: K
authors.lastname: Tasanen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology*; D010391:Pemphigoid, Bullous / Q000453:epidemiology*; D012042:Registries; D012189:Retrospective Studies