Partner bereavement and risk of psoriasis and atopic eczema: cohort studies in the United Kingdom and Denmark.
BACKGROUND: Stress is commonly cited as a risk factor for psoriasis and atopic eczema, but such evidence is limited.
OBJECTIVES: To investigate the association between partner bereavement (an extreme life stressor) and psoriasis or atopic eczema.
METHODS: We conducted cohort studies using data from the UK Clinical Practice Research Datalink (1997-2017) and Danish nationwide registries (1997-2016).
Exposed cohort: Partners who experienced partner bereavement.
Comparison cohort: Up to 10 non-bereaved partners, matched to each bereaved partner by age, sex, county of residence (Denmark), and general practice (UK). Outcomes were the first recorded psoriasis or atopic eczema diagnosis. We estimated hazard ratios (HRs), using a stratified Cox proportional hazards model in both settings, that were then pooled in a meta-analysis.
RESULTS: The pooled adjusted HRs for the association between bereavement and psoriasis were 1.01 [95%confidence interval(CI), 0.98-1.04] across the entire follow-up. Similar results were found in other shorter follow-up periods. Pooled adjusted HRs for the association between bereavement and atopic eczema were 0.97(95%CI, 0.84-1.12) across the entire follow-up, 1.09(95%CI, 0.86-1.38) within 0-30 days, 1.18(95%CI, 1.04-1.35) within 0-90 days, 1.14(95%CI, 1.06-1.22) within 0-365 days, and 1.07(95%CI, 1.02-1.12) within 0-1095 days.
CONCLUSIONS: We found a modest increase in risk of atopic eczema within three years following bereavement, which peaked in the first three months. Acute stress may play a role in triggering onset of new atopic eczema or relapse of atopic eczema previously in remission. We observed no evidence for increased long-term risk of psoriasis and atopic eczema following bereavement.
|ジャーナル名||The British journal of dermatology|
|投稿者||Wong, A Y S; Froslev, T; Forbes, H J; Kjaersgaard, A; Mulick, A; Mansfield, K; Silverwood, R J; Sorensen, H T; Smeeth, L; Schmidt, S A J; Langan, S M|
|組織名||Faculty of Epidemiology and Population Health, London School of Hygiene and;Tropical Medicine, London, United Kingdom.;Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.;Health Data Research, UK.;Centre for Longitudinal Studies, Department of Social Science, University College;London, London, United Kingdom.;Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.|