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Partner bereavement and risk of psoriasis and atopic eczema: cohort studies in the United Kingdom and Denmark

Wong, AYS; Frøslev, T; Forbes, HJ; Kjærsgaard, A; Mulick, A; Mansfield, K; Silverwood, RJ; ... Langan, SM; + view all (2020) Partner bereavement and risk of psoriasis and atopic eczema: cohort studies in the United Kingdom and Denmark. British Journal of Dermatology 10.1111/bjd.18740. (In press). Green open access

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Abstract

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 U.K. Clinical Practice Research Datalink (1997–2017) and Danish nationwide registries (1997–2016). The exposed cohort was partners who experienced partner bereavement. The comparison cohort was up to 10 nonbereaved partners, matched to each bereaved partner by age, sex, county of residence (Denmark) and general practice (U.K.). Outcomes were the first recorded diagnosis of psoriasis or atopic eczema. We estimated hazard ratios (HRs) and confidence intervals (CIs) using a stratified Cox proportional hazards model in both settings, which were then pooled in a meta‐analysis. Results: The pooled adjusted HR for the association between bereavement and psoriasis was 1·01 (95% 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 the risk of atopic eczema within 3 years following bereavement, which peaked in the first 3 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.

Type: Article
Title: Partner bereavement and risk of psoriasis and atopic eczema: cohort studies in the United Kingdom and Denmark
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/bjd.18740
Publisher version: https://doi.org/10.1111/bjd.18740
Language: English
Additional information: © 2019 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute
URI: https://discovery.ucl.ac.uk/id/eprint/10087740
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