Lichen Sclerosus Significantly Associated with Depression, Anxiety

Jeffrey Cohen, MD

New data from Yale School of Medicine indicated that lichen sclerosus (LS) was significantly associated with depression and anxiety in American women, with those affected by the inflammatory conditions having a 2.16- and 2.5-fold increase in odds of comorbid depression or anxiety diagnoses, respectively.

Lichen sclerosus- which predominantly affects the anogenital area in female patients- has been associated with increased psychological distress and decreased quality of life in previous research.

Despite this, the implications of depression and anxiety in patients with LS remains poorly understood.

As such, an investigative team led by Jeffrey M. Cohen, MD, from the Department of Dermatology at the Yale School of Medicine.

Cohen and colleagues enrolled adult women from the All of Us Research Program, a specific database from the National Institutes of Health that offered extensive clinical data on a diverse cohort of women featuring 214,206 adults in the US.

Between May, 6, 2019 to February 11, 2022, the team searched the cohort for US women who were 18 years and older prior to using electronic health record (HER) data to identify LS, depression, and anxiety.

From there, all eligible patients were matched to 4 control individuals on age, sex, race, and ethnicity, and logistic regression was used to determine odds ratios (ORs) related to whether LS was associated with depression or anxiety.

Overall, the team identified 765 women with LS with a mean age of 66.2 years, in addition to 3060 matched controls.

They observed that women with the inflammatory condition were more likely to be diagnosed with depression (45%) compared to those without LS (24.4%) (P<.001). Women with LS were also more likely to be diagnosed with anxiety compared to those without the condition at 42.6% and 22.6%, respectively.

Finally, a multivariable analysis showed that LS was significantly associated with depression and anxiety (P<.001).

Though Cohen and colleagues noted some limitations to the study, such as the lack of clinical data on treatment, severity, and duration of LS, theirs was among the few studies to evaluate depression and anxiety in women affected by LS.

The team believed these associations were attributable to the chronic nature of the disease as well as negative associations with quality of life and sexual function in affected women.

"Health professionals treating patients with LS should recognize the increased risk of depression and anxiety, consider mental health screening, and refer patients with LS to mental health professionals when appropriate," the team wrote.