Risk of anxiety and depression in patients with lichen planus: A nationwide population-based study

Background: This study aims to determine the risk of developing anxiety and/or depression among patients with lichen planus. Methods: Based on the Longitudinal Health Insurance Database of Taiwan National Health Insurance Research Database, a total of 4012 patients with lichen planus and 16,048 matched controls (1:4) were enrolled between January 1, 2000, and December 31, 2015. After controlling for the risk variables, multivariate Cox proportional hazard regression and the log-rank test with Kaplan-Meier method were performed to assess the influence of anxiety/depression among individuals with lichen planus under a maximum follow-up period of 16 years. Results: The subsequent anxiety or depression incidence of the lichen planus group and the comparisons was 19.67% (1962.70 per 105 person-years) and 10.11% (982.23 per 105person-years), respectively. Additionally, after adjustment of the risk variables, the hazard ratios for anxiety, depression, anxiety without depression, depression without anxiety, anxiety or depression, and both anxiety and depression combined were 1.779 (95% CI: 1.289-2.477, p < 0.001), 2.010 (95%CI: 1.454-2.790, p < 0.001), 2.015 (95%CI: 1.463-2.799, p < 0.001), 2.356 (95%CI: 1.705-3.286, p < 0.001), 2.011 (95%CI: 1.457-2.793, p < 0.001), and 1.515 (95%CI: 1.100-2.134, p < 0.001), respectively. Limitations: Individuals with lichen planus were unable to be classified into oral subtype and cutaneous subtype based on the ICD-9-CM. Moreover, the results of our study could not demonstrate the mechanism between lichen planus and anxiety and/or depression. Conclusion: Patients with lichen planus was positively associated with developing anxiety or depression. Physicians should to be aware of the signs of anxiety and/or depression while facing the patients with lichen planus during the clinical practices.

Automated summary

This study aims to determine the risk of developing anxiety and/or depression among patients with lichen planus. Based on the analysis of the Taiwan National Health Insurance Research Database, the study found that patients with lichen planus have a higher incidence of anxiety and/or depression.