Background: Non-infection caused urticaria is a common ailment in adolescents. Its symptoms (e.g., unusual rash\nappearance, limitation of daily activities, and recurrent itching) may contribute to the development of depressive\nstress in adolescents; the potential link has not been well studied. This study aimed to investigate the risk of major\ndepression after a first-attack and non-infection caused urticaria.\nMethods: This study used the Taiwan Longitudinal Health Insurance Database. A total of 5,755 adolescents hospitalized\nfor a first-attack and non-infection caused urticaria from 2005 to 2009 were recruited as the study group, together with\n17,265 matched non-urticarial enrollees who comprised the control group. Patients who had any history of urticaria or\ndepression prior to the evaluation period were excluded. Each patient was followed for one year to identify the\noccurrence of depression. Cox proportional hazards models were generated to compute the risk of major depression,\nadjusting for the subjects� sociodemographic characteristics. Depression-free survival curves were also analyzed.\nResults: Thirty-four (0.6%) adolescents with non-infection caused urticaria and 59 (0.3%) non-urticarial control subjects\nsuffered a new-onset episode of major depression during the study period. The stratified Cox proportional analysis\nshowed that the crude hazard ratio (HR) of depression among adolescents with urticaria was 1.73 times (95% CI,\n1.13-2.64) than that of the control subjects without urticaria. Moreover, the HR were higher in physical (HR: 3.39, 95% CI\n2.77-11.52) and allergy chronic urticaria (HR: 2.43, 95% CI 3.18-9.78).\nConclusion: Individuals who have a non-infection caused urticaria during adolescence are at a higher risk of developing\nmajor depression.
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