Completed suicide in patients with skin disease: A systematic review and meta-analysis

IF 8 2区医学 Q1 DERMATOLOGY Journal of the European Academy of Dermatology and Venereology Pub Date : 2025-03-17 DOI:10.1111/jdv.20609

B. Hrvatin Stancic, M. A. S. Henning, N. Eriksen, J. Emilie Dornonville de la Cour, D. M. L. Saunte, G. B. E. Jemec

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Abstract

Background

Several skin diseases have been associated with suicidality. However, the term ‘suicidality’ encompasses ideation, which weakens the conclusions. In contrast, the much stronger endpoint of completed suicide and skin disease remains ambiguous.

Objectives

To determine the risk of completed suicide in adult patients with skin diseases.

Methods

The Pubmed, Embase and PsycINFO databases were performed from inception up to June 2023. All original studies in English with a minimum of 10 adult patients that assessed the relationship between a skin disease and death by suicide, were eligible for inclusion.

Results

Thirty-seven met the inclusion criteria. Owing to expected interstudy variations, a random effects model was used. A total of 13 skin diseases were identified: 17 population-based high-quality studies, 3,800,748 patients with skin disease, and 33,722,675+ controls were included in the meta-analysis (MA). Each skin disease was analysed separately. Psoriasis: six studies were included in the MA (odds ratio (OR): 1.42, 95% confidence interval (CI) (0.76; 2.68) and found no association. Dermatitis: five studies were included in the MA OR: 1.54, 95% CI (0.57; 4.17) and found no association. Melanoma: four studies were included in the MA, which found an association between melanoma and suicide Standardized mortality rate (SMR): 2.89, 95% CI (1.97; 3.81). Non-melanoma skin cancer: two studies were included in the MA; female patients showed an increased risk of completed suicide compared to the control group SMR: 1.30, 95% CI (1.12; 1.49). In patients with hidradenitis suppurativa, two studies were included in the MA OR: 2.86, 95% CI (1.56; 5.24) and showed a positive association between HS and completed suicide.

Conclusions

Suicidality should be considered by physicians when treating dermatological disease, especially when treating patients with hidradenitis suppurativa and melanoma. The association between other skin diseases and completed suicide remains unclear, and further research is indicated.

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皮肤病患者自杀：一项系统综述和荟萃分析

背景：几种皮肤病与自杀有关。然而，“自杀”一词包含了意念，这削弱了结论。相比之下，完全自杀和皮肤病的更强的终点仍然不明确。目的：了解成人皮肤病患者自杀未遂的风险。方法：检索Pubmed、Embase和PsycINFO数据库，检索时间为成立至2023年6月。所有至少有10名成年患者的英文原始研究，评估皮肤病与自杀死亡之间的关系，均符合纳入条件。结果：37例符合纳入标准。由于预期的研究间变化，采用随机效应模型。总共确定了13种皮肤病：17项基于人群的高质量研究，3,800,748例皮肤病患者和33,722,675例对照纳入meta分析（MA）。每种皮肤病分别进行分析。牛皮癣：6项研究被纳入MA(优势比（OR）： 1.42, 95%可信区间（CI） (0.76；2.68)，没有发现关联。皮炎：MA纳入了5项研究OR: 1.54, 95% CI (0.57；4.17)，没有发现关联。黑色素瘤：MA纳入了四项研究，发现黑色素瘤与自杀之间存在关联。标准化死亡率（SMR）： 2.89, 95% CI (1.97；3.81)。非黑色素瘤皮肤癌：两项研究被纳入MA；与对照组相比，女性患者完成自杀的风险增加SMR: 1.30, 95% CI (1.12；1.49)。在化脓性汗腺炎患者中，两项研究被纳入MA OR: 2.86, 95% CI (1.56；5.24)， HS与自杀未遂呈正相关。结论：医生在治疗皮肤病时应考虑自杀，特别是在治疗化脓性汗腺炎和黑色素瘤患者时。其他皮肤病与自杀之间的关系尚不清楚，需要进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the European Academy of Dermatology and Venereology 医学-皮肤病学

CiteScore

10.70

自引率

8.70%

发文量

874

审稿时长

3-6 weeks

期刊介绍： The Journal of the European Academy of Dermatology and Venereology (JEADV) is a publication that focuses on dermatology and venereology. It covers various topics within these fields, including both clinical and basic science subjects. The journal publishes articles in different formats, such as editorials, review articles, practice articles, original papers, short reports, letters to the editor, features, and announcements from the European Academy of Dermatology and Venereology (EADV). The journal covers a wide range of keywords, including allergy, cancer, clinical medicine, cytokines, dermatology, drug reactions, hair disease, laser therapy, nail disease, oncology, skin cancer, skin disease, therapeutics, tumors, virus infections, and venereology. The JEADV is indexed and abstracted by various databases and resources, including Abstracts on Hygiene & Communicable Diseases, Academic Search, AgBiotech News & Information, Botanical Pesticides, CAB Abstracts®, Embase, Global Health, InfoTrac, Ingenta Select, MEDLINE/PubMed, Science Citation Index Expanded, and others.