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Association of psychiatric comorbidities with chronic urticaria: a nested case-control study in the All of Us

Nana Ama Adjei-Frimpong1, Julian Cortes1, Savannah K Fakhouri2

  • 1Department of Dermatology, University of California San Diego, San Diego, CA, U.S.A.

JEADV Clinical Practice
|October 27, 2025
PubMed

Insights

Chronic urticaria (CU) is linked to a higher risk of psychiatric disorders, including ADHD, anxiety, and depression. Early psychiatric screening for CU patients is crucial for timely intervention and improved management.

Area of Science:

  • Dermatology and Psychiatry
  • Epidemiology
  • Clinical Research

Background:

  • Chronic urticaria (CU) involves recurrent hives and angioedema lasting over six weeks.
  • CU patients exhibit a higher prevalence of psychiatric comorbidities.
  • Limited research exists on this association in diverse populations.

Purpose of the Study:

  • To investigate the association between chronic urticaria and psychiatric disorders.
  • To utilize the All of Us database for research in underrepresented populations.

Main Methods:

  • A nested case-control study design was employed.
  • 1171 CU cases were matched 4:1 with controls from the All of Us program.
  • Logistic regression models assessed psychiatric comorbidities, adjusted for relevant conditions.

Main Results:

  • CU showed significant associations with increased odds of ADHD, anxiety, depression, dysthymia, insomnia, psychological stress, PTSD, and substance use disorder.
  • Odds ratios ranged from 2.13 to 3.92 for various psychiatric conditions.
  • The study identified a substantial psychiatric burden in CU patients.

Conclusions:

  • Chronic urticaria is significantly associated with a wide range of psychiatric disorders.
  • Routine psychiatric screenings are recommended for CU patients to facilitate early intervention.
  • Further prospective studies are needed to explore additional disorders and underlying mechanisms.
Abstract

Keywords:
chronic urticariageneral dermatologymedical dermatologypsychiatric comorbiditiespsychocutaneous medicinepsychodermatology

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