Bipolar Disorder Associated with Another Autoimmune Disease-Pemphigus: A Population-based Study

Area of Science:

• Neuroscience
• Immunology
• Epidemiology

Background:

• Emerging evidence highlights the role of inflammation and immune dysregulation in the neuroprogression of bipolar disorder (BD).
• Autoimmune comorbidities are increasingly reported in association with BD, yet the specific link with pemphigus remains unclear.

Purpose of the Study:

• To investigate the epidemiological association between pemphigus and bipolar disorder (BD).
• To estimate the risk of BD in patients diagnosed with pemphigus using real-world data.

Main Methods:

• A cross-sectional study utilizing a large-scale Israeli health database (Clalit Health Services).
• Comparison of BD prevalence between 1,985 pemphigus cases and 9,874 matched controls.
• Logistic regression analysis to identify pemphigus as an independent risk factor for BD, adjusting for multiple covariates.

Main Results:

• The prevalence of BD was significantly higher in patients with pemphigus (1.0%) compared to controls (0.5%) (P=0.023).
• This association was more pronounced in patients of Jewish ethnicity.
• Pemphigus remained a significant independent risk factor for BD (OR=1.7; 95% CI, 1.0-2.9) after controlling for confounders.

Conclusions:

• Pemphigus demonstrates a significant association with bipolar disorder.
• Clinical recommendation for assessing pemphigus patients for comorbid BD.
• Call for experimental research to elucidate the biological pathways connecting pemphigus and BD.