Pemphigus not significantly associated with Psychiatric Disorders: Study
A new study published in the journal of JID Innovations revealed that pemphigus is not significantly associated with an increased risk of most psychiatric disorders when compared to matched controls, which challenges earlier findings from smaller or less rigorous studies and highlights the importance of well-designed, large-scale cohort analyses.
Pemphigus is a severe autoimmune blistering disease in which the body produces antibodies that attack proteins responsible for holding skin cells together. This leads to fragile blisters and painful erosions of the skin and mucous membranes, often making eating, speaking, and daily activities difficult. Because many dermatological conditions are associated with anxiety, depression, and other mental health issues, pemphigus has long been suspected to carry a elevated psychiatric risk as well.
To investigate this link, this study used the US TriNetX Collaborative Network, a federated database that includes electronic health records from more than 120 million individuals. The study focused on adults aged 18 and older who had been diagnosed with pemphigus. Each patient with pemphigus was matched one-to-one with a comparison individual without pemphigus, resulting in 5,753 people in each group. Matching was carefully performed based on age, sex, ethnicity, and major medical comorbidities to ensure fair comparison.
The study tracked the development of a wide range of psychiatric conditions after the initial diagnosis. These included depression, anxiety disorders, psychotic disorders, bipolar disorder, substance use disorders, stress-related disorders, eating disorders, attention-deficit hyperactivity disorder, borderline personality disorder, suicidal ideation, and suicide attempts. Diagnoses were identified using standardized ICD-10 clinical codes, allowing for consistent classification across healthcare systems.
The results compared the incidence rates of each psychiatric disorder between the pemphigus group and the matched control group. For every psychiatric category assessed, the rates were statistically similar in both groups. No disorder demonstrated a significantly higher incidence among pemphigus patients. Additional columns summarized hazard ratios and confidence intervals, which reinforced that none of the observed differences suggested an increased psychiatric risk linked to pemphigus.
The 3 sensitivity analyses tested whether the results would change when accounting for different follow-up durations, varying completeness of baseline medical data, and long-term stability of outcomes. Across all these analyses, the findings remained consistent. Overall, the study suggests that despite its physical severity and impact on quality of life, pemphigus does not appear to independently increase the risk of developing psychiatric disorders.
Source:
Emtenani, S., Alfarsi, S., Curman, P., Olbrich, H., Engin, R. M., Ludwig, R. J., & Schmidt, E. (2026). Pemphigus Is not Associated with an Increased Risk of Psychiatric Disorders during the Course of the Disease. JID Innovations: Skin Science From Molecules to Population Health, 6(1), 100432. https://doi.org/10.1016/j.xjidi.2025.100432
