Pemphigus and depression comorbidity: a case control study.

Background: While quality of life can be significantly affected in pemphigus patients, few studies have systematically investigated the co-morbidity of psychiatric disorders in these patients.

Objective: To assess the association between pemphigus and depression comorbidity, using the computerized medical database of Israel's largest health maintenance organization.

Methods: In a case-control study, co-morbidities of adult pemphigus patients retrieved from the database of a large healthcare organization from 1998 to 2010 were compared with age- and gender-matched controls from the same database. The main outcome measure was the prevalence of co-morbid psychiatric disorders (anxiety, psychosis, schizophrenia and depression) in pemphigus patients and controls. The study included 255 pemphigus patients (157 women (62%) and 98 (38%) men) and 509 controls (313 women (62%) and 196 (38%) men) aged 20 years and older (a ratio of 3:2 in both groups). Mean age was 63.5 ± 15.7 years in the pemphigus group and 63.2 ± 15.7 years in the control group.

Results: Depression was the only psychiatric disorder significantly increased among pemphigus patients compared with controls. Alcohol abuse and smoking did not differ between groups. Depression was over-represented in a large population of pemphigus patients, indicating the disorder as a possible significant co-morbidity. After controlling for confounders including age, gender, and duration of corticosteroid therapy, the association with depression persisted (OR = 1.19, 95% CI: 1.12-1.27), p<0.001).

Conclusion: The increased prevalence of depressive morbidity, especially in the presence of commonly prescribed corticosteroid treatment, emphasizes the need for psychiatric assessment and intervention in these patients.