Suicidal ideation in patients with skin conditions: A multicentre European study

J Eur Acad Dermatol Venereol. 2026 Jun 5. doi: 10.1111/jdv.70523. Online ahead of print.

ABSTRACT

BACKGROUND: Suicidal ideation is a significant, often overlooked, concern in dermatology. Individuals with skin diseases frequently experience psychological distress, including depression, anxiety, stigma and dissatisfaction with appearance, all of which are known risk factors for suicidality. Despite this, large-scale multicentre data across different dermatological conditions in Europe remain scarce.

OBJECTIVES: To determine the prevalence of suicidal ideation among dermatological outpatients across Europe and to identify sociodemographic, clinical and psychological factors associated with general and skin-related suicidal ideation.

METHODS: This cross-sectional multicentre study included adults with dermatological conditions from 22 outpatient clinics in 17 European countries. Suicidal ideation was assessed through questions on lifetime suicidal thoughts and their attribution to skin disease. Sociodemographic, socio-economic and clinical variables were collected, together with psychological indicators: depression (PHQ-2), anxiety (GAD-2), perceived stigmatization (PSQ) and satisfaction with appearance. Group comparisons were conducted using chi-square tests, t-tests and ANOVA. Multivariable logistic regression identified independent predictors of suicidal ideation.

RESULTS: Among 5386 respondents, 13.7% reported suicidal ideation and 7.0% attributed it to their skin condition, compared with 8.4% in controls. Prevalence varied across subgroups, being higher in younger participants, single individuals, those reporting low income, stressful events or economic difficulties. Higher rates were also associated with underweight BMI, greater disease severity, presence of flares and symptoms such as itch or burning. Psychodermatological conditions, hidradenitis suppurativa, hyperhidrosis, atopic dermatitis, chronic prurigo and psoriasis showed the highest prevalence. In multivariable analysis, independent predictors included younger age, being single, low BMI, stressful events, depression, anxiety, high stigmatization and dissatisfaction with appearance.

CONCLUSIONS: Suicidal ideation is elevated in European dermatology patients and is strongly associated with psychological distress, socio-economic vulnerability and negative body perception. Routine screening for mental health symptoms and suicidal ideation should become a standard component of dermatological care to ensure early identification and support of at-risk individuals.

PMID:42246602 | DOI:10.1111/jdv.70523