Risk of first‐time and recurrent depression in patients with psoriasis: a population‐based cohort study

Egeberg, Alexander; Thyssen, Jacob P.; Wu, Jashin J.; Skov, Lone

doi:10.1111/bjd.17208

Cited by 35 publications

(36 citation statements)

References 25 publications

(23 reference statements)

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“…The worldwide prevalence rates of psoriasis range from 0.9–8.5% in adults and 0–2.1% in children (2). Although this condition rarely poses a threat to life, the irritation, pain and especially the aberrant appearance make these patients susceptible to psychological problems, such as anxiety and depression (3,4). With recent advances in the understanding of psoriasis, an increasing number of therapies have emerged, however a high recurrence rate persists.…”

Section: Introductionmentioning

confidence: 99%

Integrated bioinformatic analysis of differentially expressed genes and signaling pathways in plaque psoriasis

et al. 2019

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Psoriasis is an immune-mediated cutaneous disorder with a high incidence and prevalence. Patients with psoriasis may experience irritation, pain and psychological problems. The cause and underlying molecular etiology of psoriasis remains unknown. In an attempt to achieve a more comprehensive understanding of the molecular pathogenesis of psoriasis, the gene expression profiles of 175 pairs of lesional and corresponding non-lesional skin samples were downloaded from 5 data sets in the Gene Expression Omnibus (GEO) database. Integrated differentially expressed genes (DEGs) were obtained with the use of R software. The gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were analyzed using the DAVID online analysis tool. The protein-protein interaction (PPI) network was constructed on the STRING platform and hub genes were calculated with the use of Cytoscape software. Finally, GEO2R was used to determine the expression of the hub genes in scalp psoriasis. A total of 373 genes from the 5 data sets were identified as DEGs, including 277 upregulated and 96 downregulated genes. GO analysis revealed that immune responses and epidermal differentiation/development were the most enriched terms in biological processes, extracellular space/matrix was the most enriched term in cellular components, and endopeptidase inhibitor activity was the most enriched term in molecular functions. In the KEGG pathway enrichment, DEGs were mainly enriched in the metabolic and viral infection-associated pathways. A total of 17 hub genes were calculated, including CSK2, CDC45, MCM10, SPC25, NDC80, NUF2, AURKA, CENPE, RRM2, DLGP5, HMMR, TTK, IFIT1, RSAD2, IFI6, IFI27 and ISG20 , among which interferon-α-inducible genes were revealed to display a similar expression pattern as that obtained in scalp psoriasis. This comprehensive bioinformatic re-analysis of GEO data provides new insights on the molecular pathogenesis of psoriasis and the identification of potential therapeutic targets for the treatment of psoriasis.

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Section: Introductionmentioning

confidence: 99%

Integrated bioinformatic analysis of differentially expressed genes and signaling pathways in plaque psoriasis

et al. 2019

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“…Additionally, 5-HT is also a main factor in depression, which is one of the main comorbidities of psoriasis. In fact, it has been reported that psoriasis is associated with a 39% increase in depression and 31% increase in anxiety [120], while a recent population-based cohort study revealed that the highest risk for depression occurred for mid-aged patients with severe forms of psoriasis and patients with a prior history of depression [121]. Moreover, the cytokine theory of depression suggests that depression and other mental disorders have hormonal and biochemical components, and might involve inflammation processes [122].…”

Section: The Role Of Serotonin In Psoriasismentioning

confidence: 99%

The Brain–Skin Connection and the Pathogenesis of Psoriasis: A Review with a Focus on the Serotonergic System

Martins¹,

Ascenso²,

Ribeiro³

et al. 2020

Cells

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Psoriasis is a common non-communicable chronic immune-mediated skin disease, affecting approximately 125 million people in the world. Its pathogenesis results from a combination of genetic and environmental factors. The pathogenesis of psoriasis seems to be driven by the interaction between innate immune cells, adaptive immune cells and keratinocytes, in a process mediated by cytokines (including interleukins (IL)-6, IL-17 and IL-22, interferon and tumor necrosis factor) and other signaling molecules. This leads to an inflammatory process with increased proliferation of epidermal cells, neo-angiogenesis and infiltration of dendritic cells in the skin. Dysfunctional de novo glucocorticoid synthesis in psoriatic keratinocytes and the skin microbiome have also been suggested as mediators in the pathogenesis of this disease. To understand psoriasis, it is essential to comprehend the processes underlying the skin immunity and neuroendocrinology. This review paper focuses on the skin as a neuroendocrine organ and summarizes what is known about the skin immune system, the brain–skin connection and the role played by the serotonergic system in skin. Subsequently, the alterations of neuroimmune processes and of the serotonergic system in psoriatic skin are discussed, as well as, briefly, the genetic basis of psoriasis.

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“…Depression and anxiety are common comorbidities among psoriasis and PsA patients which may be a result of psychosocial difficulties as well as common inflammatory pathways. [1][2][3][4][5][6][7] However, little is known about whether systemic treatments for psoriasis and PsA are associated with an increased risk of anxiety and depression, and whether these risks differ between the various treatments. Short-term clinical trials reported a somewhat elevated risk of depression in apremilast users, resulting in a label warning.…”

Section: Introductionmentioning

confidence: 99%

“…Apremilast is an oral medication used to treat psoriasis and psoriatic arthritis (PsA) by inhibiting phosphodiesterase‐4, a protein found in immune cells associated with inflammation. Depression and anxiety are common comorbidities among psoriasis and PsA patients which may be a result of psychosocial difficulties as well as common inflammatory pathways . However, little is known about whether systemic treatments for psoriasis and PsA are associated with an increased risk of anxiety and depression, and whether these risks differ between the various treatments.…”

Section: Introductionmentioning

confidence: 99%

The risk of treated anxiety and treated depression among patients with psoriasis and psoriatic arthritis treated with apremilast compared to biologics, DMARDs and corticosteroids: a cohort study in the United States MarketScan database

Vasilakis‐Scaramozza

Persson

Hagberg

et al. 2020

Acad Dermatol Venereol

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Background Anxiety and depression are common among psoriasis and psoriatic arthritis (PsA) patients, but rates may differ by treatment. Objective To quantify the risk of incident treated anxiety, depression and mixed anxiety + depression in users of apremilast compared with users of other treatments for psoriasis and PsA. Methods We conducted two separate cohort studies of psoriasis and PsA patients treated with apremilast, tumour necrosis factor inhibitor biologics, interleukin-17,-23 or-12/23 inhibitor biologics, conventional DMARDs or systemic corticosteroids in the United States MarketScan database. Cohort entry was date of first study drug after 21 March 2014. We identified cases who had a depression and/or anxiety diagnosis with a prescription for antidepressant/antianxiety medication within 30 days of the diagnosis code. We calculated incidence rates (IRs) and incidence rate ratios with 95% confidence intervals (CIs) for treated anxiety, treated depression and treated anxiety + depression per 1000 patient-years (PY) among patients. Results Among the psoriasis cohort, IRs for each outcome were similar between exposure categories and highest among users of systemic corticosteroids alone. IRs (95% CI) for apremilast alone were 9.2 (6.6-12.5), 4.6 (2.8-7.1) and 4.6 (2.8-7.1) per 1000 PY for treated anxiety, treated depression and treated anxiety + depression, respectively. In the PsA cohort, the rate of anxiety was highest among users of apremilast alone; rates of depression and anxiety + depression were similar for apremilast compared with other PsA treatments. IRs for each outcome were also high for users of corticosteroids in both the psoriasis and PsA cohorts. Conclusions Among patients with psoriasis, users of apremilast had similar rates of anxiety and depression as users of other non-corticosteroid systemic psoriasis treatments. Among PsA patients, users of apremilast had similar rates of depression and anxiety + depression compared with users of other systemic non-corticosteroid PsA drugs; however, the rate of anxiety was slightly higher.

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Risk of first‐time and recurrent depression in patients with psoriasis: a population‐based cohort study

Abstract: Psoriasis was independently associated with risk of depression. These results may help clinicians identify particularly high-risk individuals.

Cited by 35 publications

References 25 publications

Integrated bioinformatic analysis of differentially expressed genes and signaling pathways in plaque psoriasis

Integrated bioinformatic analysis of differentially expressed genes and signaling pathways in plaque psoriasis

The Brain–Skin Connection and the Pathogenesis of Psoriasis: A Review with a Focus on the Serotonergic System

The risk of treated anxiety and treated depression among patients with psoriasis and psoriatic arthritis treated with apremilast compared to biologics, DMARDs and corticosteroids: a cohort study in the United States MarketScan database

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