Incidence rates of suicidal behaviors and treated depression in patients with and without psoriatic arthritis using the Clinical Practice Research Datalink

Journal: Modern Rheumatology

Authors: Katrina Wilcox HagbergLin LiMichael Peng, Kamal ShahMaria ParisSusan Jick

NLM Citation: Hagberg KW, Li L, Peng M, Shah K, Paris M, Jick S. Incidence rates of suicidal behaviors and treated depression in patients with and without psoriatic arthritis using the Clinical Practice Research Datalink. Mod Rheumatol. 2016 Sep;26(5):774-9. doi: 10.3109/14397595.2015.1136726. Epub 2016 Feb 16. PMID: 26882216; PMCID: PMC5020333.

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.

Keywords: Depression; Psoriatic arthritis; Suicidal ideation; Suicide; Suicide attempt.

Figures

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Figure 1. Cumulative incidence of suicidal ideation (A), suicide attempts (B), and suicide (C) in the psoriatic arthritis and comparison cohorts.
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Figure 2. Cumulative incidence of treated depression in the psoriatic arthritis and comparison cohorts.