Urticaria Cronica y padecimientos psiquiátricos

Published in Dermatology

Journal Scan / Research · October 11, 2019

Patients With Chronic Urticaria Have a Higher Risk of Psychiatric Disorders

The British Journal of Dermatology

Abstract

BACKGROUND

The prevalence of psychiatric comorbidities in patients with chronic urticaria (CU) in a national population is largely unknown.

OBJECTIVES

To investigate the prevalence of psychiatric disorders and psychiatric medication use in patients with CU in Taiwan.

METHODS

Data were sourced from Taiwan's National Health Insurance Research Database for 2011. Patients who had a primary/secondary International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code of 708·1, 708·8 or 708·9 during 2011 with at least two outpatient visits and an antihistamine prescription were identified as CU cases. Patients with CU were classified into three disease severity groups according to their medication types. Psychiatric disorders were identified by patients having three outpatient visits with a primary or secondary diagnosis of a given psychiatric disease. Psychiatric medication use was defined by having at least four outpatient visits with prescriptions for anxiolytics, antidepressants or sleeping pills in 2010 or 2011.

RESULTS

Of the 167 132 patients with CU, 82·5% had mild CU, 17·0% had moderate CU and 0·4% had severe CU. Patients with CU had a higher prevalence of psychiatric disorders and psychiatric medication prescription than control groups. The relative risk (RR) of psychiatric disorders was 1·43 for patients with mild, 1·50 for patients with moderate and 2·32 for patients with severe CU vs. the controls (P < 0·001). For psychiatric medication prescription, the RRs were 1·95, 2·70 and 2·09, respectively, vs. controls (P < 0·001).

CONCLUSIONS

Patients with CU had a higher prevalence and risk of psychiatric disorders and psychiatric medication prescription than control groups. What's already known about this topic? Previous studies have shown a high prevalence of psychiatric comorbidities in patients with chronic urticaria (CU), with rates ranging from 35% to 60%. Anxiety, depression and somatoform disorders have been reported as the most prevalent mental disorders in patients with CU. What does this study add? Patients with CU had a higher prevalence of psychiatric disorders and psychiatric medication use than control groups in the general population. The relative risk (RR) of psychiatric disorders was 1·43 for those with mild CU, 1·50 for those with moderate CU and 2·32 for those with severe CU vs. controls. The RR for psychiatric medication use was 1·95 for those with mild CU, 2·70 for those with moderate CU and 2·09 for those with severe CU vs. controls. Mental health evaluations and management are important elements in CU management.

TAKE-HOME MESSAGE

• This study used a Taiwanese national database to identify 167,132 patients with chronic urticaria (CU). The majority of patients were classified as having mild CU (82.5%); only 0.4% had severe CU. The prevalence of psychiatric disorders ranged from 7.0% to 11.8% and was variable based on the severity of CU. The relative risk of psychiatric disorders was 1.43 in people with mild CU, 1.50 in moderate CU, and 2.32 in severe CU (P<.001).

• The risk of psychiatric disorders appears to be higher in patients with chronic urticaria compared with controls. In patients with chronic urticaria, mental health evaluation should be an important aspect of management.

– Caroline Crabtree, MD

The British Journal of Dermatology

Patients With Chronic Urticaria Have a Higher Risk of Psychiatric Disorders: A Population-Based Study

Br J Dermatol 2019 Jun 20;[EPub Ahead of Print], CY Chu, YT Cho, JH Jiang, CC Chang, SC Liao, CH Tang 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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