Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting 18 million adults (7.2%) and 9.6 million children (13%) in the United States. Many psychiatric comorbidities are associated with AD.
Patients with AD are at significantly increased risk of suicidal ideation and suicide attempts than the general population, according to findings from a systematic review and meta-analysis.
April Armstrong, MD, MPH, was part of the team of researchers that conducted the study, published in JAMA Dermatology.[i] Armstrong is associate dean of clinical research and professor of dermatology at the Keck School of Medicine of USC.
Key Findings About AD and Suicide
Key study findings are:
- Compared to people without AD, patients with AD, are:
- 44 percent more likely to exhibit suicidal ideation (pooled odds ratio, 1.44; 95% CI, 1.25-1.65)
- 36 percent more likely to attempt suicide (pooled odds ratio, 1.36; 95% CI, 1.09-1.70).
- Results of studies about completed suicides in patients with AD were inconsistent.
Dermatologists should be aware of the risk of suicide among patients with AD, say the researchers. They should screen these patients for suicidality and make referrals to mental health providers when necessary.
Researchers reviewed 15 observational studies evaluating suicidal ideation, suicide attempts, and completed suicide among patients with AD. The studies covered:
- 310,681 AD patients:
- 52.7% female
- 47.3% male
- More than 4.4 million people without AD:
- 50.9% female
- 49.1% male.
Study on Psoriasis and Suicide
In a separate systematic review and meta-analysis of psoriasis and suicidality, Armstrong and other researchers found that:
- Patients with psoriasis were twice as likely to consider suicide as the general population
- Psoriasis was significantly associated with both attempted and completed suicide.
This study, published in the Journal of the American Academy of Dermatology,[ii] focused on 18 studies covering more than 1.76 million participants, including 330,207 patients with psoriasis.
Advancing Dermatologic Care
USC Dermatology at Keck Medicine of USC manages rare and common skin diseases, such as psoriasis, atopic dermatitis, skin cancer, infectious diseases, autoimmune diseases and immunobullous diseases. Physicians see many patients with skin disorders or unusual presentations of common skin diseases.
Dr. Armstrong is one of the many of physicians who engage in groundbreaking dermatologic research. Keck Medicine of USC ranks in the top 10 in NIH funding for dermatology research, keeping USC Dermatology in the forefront of advancing care.
[i] Sandhu JK, Wy JJ, Bui RL, Armstrong AW. Association Between Atopic Dermatitis and Suicidality: A Systematic Review and Meta-analysis. JAMA Dermatology, 2018 Dec 12. doi: 10.1001/jamadermatol.2018.4566
[ii] Singh S, Taylor C, Kornmehl H, Armstrong AW. Psoriasis and suicidality: A systematic review and meta-analysis. Journal of the American Academy of Dermatology. September 2017, 77(3): 425–440.e2.