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Depression and the risk of psoriasis in US women

Authors

  • P.L. Dominguez,

    1. Department of Dermatology
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  • J. Han,

    1. Department of Dermatology
    2. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
    3. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
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  • T. Li,

    1. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
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  • A. Ascherio,

    1. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
    2. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
    3. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
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  • A.A. Qureshi

    Corresponding author
    1. Department of Dermatology
    2. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
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  • Conflict of Interest
    Dr. Qureshi serves as a consultant to the Centers for Disease Control and Novartis. Drs. Dominguez, Han, Li and Ascherio have no conflicts of interest to declare. The authors have not published or submitted any related papers from this study.

  • Funding sources
    This study was supported in part by a grant from the Department of Dermatology, Brigham and Women’s Hospital to AAQ. The NHSII cohort follow-up is funded by NIH CA50385.

Abrar A. Qureshi. E-mail:abrar.qureshi@channing.harvard.edu

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.

Objectives  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.

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