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Open Access 01-12-2020 | Schizophrenia | Research article

Psychiatric comorbidity in individuals with bullous pemphigoid and all bullous disorders in the Danish national registers

Authors: Marianna Rania, Liselotte Vogdrup Petersen, Michael Eriksen Benros, Zhi Liu, Luis Diaz, Cynthia M. Bulik

Published in: BMC Psychiatry | Issue 1/2020

Abstract

Background

Bullous pemphigoid (BP) is an autoimmune blistering skin disease that takes a profound physical and mental toll on those affected. The aim of the study was to investigate the bidirectional association between BP and all bullous disorders (ABD) with a broad array of psychiatric disorders, exploring the influence of prescribed medications.

Methods

This nationwide, register-based cohort study encompassed 6,470,450 individuals born in Denmark and alive from 1994 to 2016. The hazard ratios (HRs) of a subsequent psychiatric disorder in patients with BP/ABD and the reverse exposure and outcome were evaluated.

Results

Several psychiatric disorders were associated with increased risk of subsequent BP (4.18-fold for intellectual disorders, 2.32-fold for substance use disorders, 2.01-fold for schizophrenia and personality disorders, 1.92–1.85-1.49-fold increased risk for organic disorders, neurotic and mood disorders), independent of psychiatric medications. The association between BP and subsequent psychiatric disorders was not significant after adjusting for BP medications, except for organic disorders (HR 1.27, CI 1.04–1.54). Similar results emerged with ABD.

Conclusion

Psychiatric disorders increase the risk of a subsequent diagnosis of BP/ABD independent of medications, whereas medications used for the treatment of BP/ABD appear to account for the subsequent onset of psychiatric disorders. Clinically, an integrated approach attending to both dermatological and psychiatric symptoms is recommended, and dermatologists should remain vigilant for early symptoms of psychiatric disorders to decrease mental health comorbidity.

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Title: Psychiatric comorbidity in individuals with bullous pemphigoid and all bullous disorders in the Danish national registers
Authors: Marianna Rania
Liselotte Vogdrup Petersen
Michael Eriksen Benros
Zhi Liu
Luis Diaz
Cynthia M. Bulik
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Schizophrenia
Bullous Pemphigoid
Affective Disorder
Affective Disorder
Published in: BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-020-02810-x

At a glance: The STEP trials

Springer Medicine

Psychiatric comorbidity in individuals with bullous pemphigoid and all bullous disorders in the Danish national registers

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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