Association between major depressive disorder and subsequent autoimmune skin diseases: A nationwide population-based cohort study

Background: : Major depressive disorder (MDD) has been implicated as a risk factor for various immune-related disorders; however, the association between MDD and subsequent autoimmune skin diseases (ASDs) remains unclear. This study aimed to investigate the association of MDD with risk of subsequent ASDs. Methods: : Subjects were recruited from the National Health Insurance Research Database in Taiwan. We included 222,522 patients with MDD and 890,088 matched controls to assess the risk of developing ASDs. Results: : After controlling for confounders, we found an increased risk of ASDs among the patients with MDD (adjusted hazard ratio [aHR], 10.41; 95% CI, 9.62–11.42) compared to matched controls. Subgroup analyses showed that MDD patients had a significantly increased risk of developing psoriasis (aHR, 12.01; 95% CI, 10.37–13.91), lichen planus (aHR, 11.84; 95% CI, 8.90–15.75), alopecia areata (aHR, 11.61; 95% CI, 9.92–13.59), morphea (aHR, 6.03; 95% CI, 2.47–14.73), autoimmune bullous diseases (aHR, 7.67; 95% CI, 5.94–9.90), hidradenitis suppurativa (aHR, 8.45; 95% CI, 3.61–19.74), vitiligo (aHR, 7.24; 95% CI, 5.65–9.28), lupus erythematosus (aHR, 11.30; 95% CI, 9.21–13.86), systemic sclerosis (aHR, 8.07; 95% CI, 4.30–15.14), Sjogren's syndrome (aHR, 6.71; 95% CI, 5.29–8.50), and dermatomyositis (aHR, 14.44; 95% CI, 5.55–37.55). Conclusions: : Patients with MDD had an increased risk of developing ASDs as compared to the controls. Further studies are needed to better understand the underlying mechanisms.