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Posttraumatic Stress Disorder and the Associated Risk of Autoimmune Skin Diseases: A Nationwide Population-Based
Ying-Xiu Dai1, Ying-Hsuan Tai, Yun-Ting Chang
1From the Department of Dermatology (Dai, Chang), Taipei Veterans General Hospital; School of Medicine (Dai, Tai, Chang, T.-J. Chen, M.-H. Chen), National Yang Ming Chiao Tung University, Taipei; Department of Anesthesiology (Tai), Shuang Ho Hospital, Taipei Medical University, New Taipei City; Department of Anesthesiology (Tai), School of Medicine, College of Medicine, Taipei Medical University; Department of Family Medicine (T-.J. Chen), Taipei Veterans General Hospital; and Department of Psychiatry (M-.H. Chen), Taipei Veterans General Hospital, Taipei, Taiwan.
Objective:
Posttraumatic stress disorder (PTSD) is known as a risk factor for various immune-related disorders; however, the association between PTSD and related autoimmune skin diseases (ASDs) remains unclear. This study aimed to investigate the association of PTSD with the risk of related ASDs.
Methods:
Participants were recruited from the National Health Insurance Research Database in Taiwan. We included 9801 patients with PTSD and 39,204 matched controls to assess the risk of developing ASDs. Cox regression model was used for analyses.
Results:
After adjusting for confounders, we found an increased risk of ASDs among the patients with PTSD (adjusted hazard ratio [aHR] = 3.00, 95% confidence interval [CI] = 2.21-4.07) compared with that among matched controls. Statistically significant associations were found between PTSD and five individual ASDs, including psoriasis (aHR = 3.81, 95% CI = 1.90-7.67), lichen planus (aHR = 31.63, 95% CI = 4.00-249.91), alopecia areata (aHR = 4.77, 95% CI = 2.47-9.20), autoimmune bullous diseases (aHR = 9.55, 95% CI = 1.98-45.99), and vitiligo (aHR = 16.06, 95% CI = 4.48-57.54).
Conclusions:
Patients with PTSD had an increased risk of developing ASDs compared with the matched controls. Further studies are needed for better understanding of the underlying mechanisms.
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