Patients with Moderate to Severe Psoriasis Associate with Higher Risk of Depression and Anxiety Symptoms: Results of a Multivariate Study of 300 Spanish Individuals with Psoriasis

Abstract

Population-based studies indicate that psoriasis associates a greater risk of comorbidities that alter mood, such as anxiety and, above all, depression. We applied a complete panel of validated questionnaires to perform a full psychopathological exploration according to the DSM-V classification of psychiatric diseases in 300 psoriatic patients. A dose-response association with depression and anxiety (the more severe psoriatic patients have more risk of having depression or anxiety) was observed. The Montgomery-Asberg Depression Rating, Hamilton Rating for Depression, Hospital Anxiety and Depression scales (for depression), and State Anxiety Inventory (for anxiety) seem to better detect such mood comorbidities in psoriatic patients. Psoriasis is a chronic skin disease associated with considerable physical and psychological comorbidities. Stress and emotional disturbances have been implicated in both triggering the onset and exacerbation of psoriasis. In order to determine the level of perceived stress and mood alterations in patients with psoriasis and their association with disease severity, 300 individuals completed diverse validated questionnaires assessing stress and psychological mood. Evaluation of perception of disease was also measured. A significant association between psoriasis severity and mood, emotional disturbances and an impact on assessments of the quality of life were observed. Particularly, Montgomery-Asberg Depression Rating Scale, Hamilton Rating Scale and Hospital Anxiety and Depression Scale for Depression detected a significant risk for depression in relation to the disease severity. The association between depression features, anxiety and perceived stress with psoriasis severity is important and can influence the appropriate management of psoriasis.

Prevalence and factors associated with depression and anxiety in patients with psoriasis

“…In Brazil, the prevalence of anxiety and depression in adults in the general population is 9.3% and 5.8%, respectively (World Health Organization (WHO), 2017). In this study, 36% of participants had anxiety, and 19% had depression, that is, higher than that presented in the Brazilian population, but lower than in other international studies with psoriasis patients (Hu et al, 2019; Lamb et al, 2017; Sethulakshmi et al, 2019; Singh et al, 2016; Tian et al, 2019; Tribó et al, 2019).…”

Oxidative stress and inflammatory response in patients with psoriasis; is there any relationship with psychiatric comorbidity and cognitive functions?

“…In concordant with the literature, psoriasis patients had higher mean BDI and BAI scores than controls [5,8,9,12,13,21,32].…”

“…In our study, duration of psoriasis was not related to psychiatric comorbidity. Other studies showed clearance of psoriasis may improve stress, patients' wellbeing, anxiety or depression symptoms, on the other side, some patients with severe psoriasis may have progressively adapted to the impact of the disease [9]. From parameters of WCST, when the duration of disease prolonged, number of categories completed decreased and number of trials until first category completed increased.…”

“…A recent study, adjusted for aggravating or improving factors of stressful life events within one preceding year, disclosed that most psoriatic patients (76%) suffered from moderate to high levels of stress. Stressful life events may represent not only a cause but also an effect [9].…”

Gender features of the influence of depressive and dissominal symptoms on the quality of life of patients with psoriasis

“…Распространенность депрессии среди больных псориазом составляет 24-30 % [13]. У пациентов с псориазом наблюдается рост числа случаев тревожных расстройств, депрессии и попыток суицида [20]. На биологическом уровне депрессия может модулировать восприятие зуда, интенсивность которого напрямую связана с тяжестью ее симптомов [10,11].…”