Increased long-term risks of depression, anxiety, stress, and suicidality in rosacea and perioral dermatitis

Rosacea and perioral dermatitis (PD) are chronic inflammatory skin conditions of the face that may adversely affect psychological well-being.

To investigate the long-term risk of depression, anxiety, stress, suicidal ideation, and suicide attempts in patients with rosacea or PD.

Large-scale, retrospective cohort study comprising over 116 million patients. Rosacea or PD patients were matched 1:1 with controls. Mental health outcomes were assessed across multiple follow-up time points.

The study included 335,314 patients with rosacea and 212,557 with PD. At five years post-diagnosis, individuals with rosacea had a significantly increased risk of depression (HR 1.488, 95 %CI 1.451-1.527, p < 0.001) and anxiety (HR 1.664), while those with PD had even higher risks (depression HR 1.799; anxiety HR 1.988). Both groups also showed markedly elevated risks for stress (rosacea HR 2.457; PD HR 2.876). All observed risks continued to increase over time. The risk of suicidal ideations was significantly increased only in the PD group (HR 1.324), while no significant associations with suicide attempts were observed.

Potential miscoding, lack of causal inferences and severity ratings.

Rosacea and PD are associated with significantly elevated long-term risks of depression, anxiety, and stress. PD may also confer increased risk of suicidal ideation.