Supplementary Material for: Association of Psoriasis with Psychiatric Hospitalization in United States Children and Adults

Background: Psoriasis is associated with psychosocial distress. Little is known about the relationship between psoriasis and mental health (MH) emergencies. Objective: To examine the associations of psoriasis and MH hospitalizations in the USA. Methods: Data from the 2002–2012 National Inpatient Sample were analyzed, including an approximately 20% sample of all US hospitalizations (n = 87,053,155 children and adults). Results: Hospitalization for MH disorders occurred more commonly in those with psoriasis compared to those without psoriasis (4.04 vs. 2.21%). In multivariable logistic regression models, psoriasis was associated with higher odds of admission for any MH disorder overall (adjusted odds ratio [95% confidence interval]: 2.32 [2.24–2.41]), as well as 9 of the 15 MH-specific disorders examined. Associated MH disorders included: anxiety, schizophrenia, personality disorder, depression, substance use disorders, history of MH disorder, alcohol-related disorders, adjustment disorders, and cognitive disorders. Children with versus those without psoriasis were also more likely to have a primary hospitalization for any MH disorder (2.82 [2.24–3.56]). Psoriasis inpatients were also more likely to have a primary hospitalization for any MH disorder compared to those with alopecia areata (1.99 [1.45–2.74]) or hidradenitis suppurativa (3.97 [3.49–4.52]). Psoriasis patients hospitalized with any MH disorder had higher mean [95% confidence interval] cost of inpatient care (USD 11,004 [10,846–11,241] vs. 9,547 [8,730–10,364]; p Conclusions: Children and adults with psoriasis had increased hospitalization for multiple MH disorders, which were associated with a considerable financial burden.背景：银屑病（Psoriasis）与心理社会困扰密切相关，但目前学界对银屑病与心理健康（Mental Health, MH）急症之间的关联尚缺乏充分认知。 研究目的：探讨美国人群中银屑病与心理健康住院事件的关联。 研究方法：本研究分析了2002-2012年美国国家住院患者样本（National Inpatient Sample, NIS）的数据，该样本覆盖全美约20%的住院病例，总样本量达87053155例儿童及成人。 研究结果：与非银屑病患者相比，银屑病患者因心理健康相关疾病住院的比例更高（4.04% vs. 2.21%）。在多变量logistic回归模型中，银屑病与总体任意心理健康疾病住院的更高风险相关，校正后优势比（95%置信区间）为2.32（2.24~2.41），同时与本次研究纳入的15种特定心理健康疾病中的9种存在显著关联。涉及的关联心理健康疾病包括：焦虑症、精神分裂症、人格障碍、抑郁症、物质使用障碍、既往心理健康疾病病史、酒精相关障碍、适应障碍及认知障碍。 与非银屑病儿童相比，银屑病儿童因任意心理健康疾病为主要诊断的住院风险同样更高（校正后优势比：2.82，95%置信区间：2.24~3.56）。与斑秃（alopecia areata）患者或化脓性汗腺炎（hidradenitis suppurativa）患者相比，银屑病住院患者因任意心理健康疾病为主要诊断住院的比例同样更高（优势比分别为1.99[1.45~2.74]和3.97[3.49~4.52]）。因任意心理健康疾病住院的银屑病患者，其住院治疗的平均费用（95%置信区间）更高（11004美元[10846~11241美元] vs. 9547美元[8730~10364美元]；p 结论：无论儿童还是成人，银屑病患者因多种心理健康疾病住院的风险均显著升高，且此类住院伴随显著的经济负担。