Psoriasis and psoriatic arthritis increase the risk of depressive symptoms

Psoriasis and psoriatic arthritis are chronic inflammatory conditions that impose a significant physical and psychological burden on affected individuals. A recent study published in the current issue of the journal Rheumatology and Therapy has reported that both psoriasis and psoriatic arthritis increase the risk of depression, thereby adversely affecting the quality of life of the subjects.

Dr. Frede and colleagues conducted the cross-sectional survey of 300 patients with psoriatic disease who visited the dermatology outpatient clinic and the rheumatology outpatient clinic at the University Medical Centre in Freiburg, Germany. Patients with psoriasis and psoriatic arthritis exhibited reduced abilities to participate in social roles and activities, as well as a higher prevalence of depressive symptoms compared to those with psoriasis alone. The researchers noted that the disease burden remained high even after treatment. They found a significant association between functional impairment in daily life and the diagnosis of psoriatic arthritis (odds ratio [OR] 9.56, P = 0.005), depressive symptoms (OR 5.44, P <0.001), and age (OR 1.04, P=0.033). The study revealed that at least mild depressive symptoms were observed in 54% of patients with psoriasis and 69% of patients with psoriatic arthritis.

A 2021 national survey published in the British Journal of Dermatology has revealed that psoriatic arthritis has a significant impact on the quality of life and mental health of individuals with psoriatic disease. The study, conducted by Gondo and colleagues from the National Psoriasis Foundation in Portland, Oregon, surveyed 1,570 individuals with psoriatic disease. The findings indicated that almost 30% of the respondents experienced limitations in their ability to participate in social roles and activities, while 23.4% reported depression symptoms in the previous two weeks. Additionally, 40% of individuals reported that their skin disease significantly affected their quality of life. The study also found that those with psoriatic arthritis experienced decreased ability to participate in social roles and activities as well as more symptoms of depression.

Dr. Frede and team pointed out that functional impairment, quality of life, and depressive symptoms are interconnected. Early diagnosis of psoriatic arthritis is crucial to prevent long-term damage, disability, and mental health complications. Anti-inflammatory therapy should be initiated as soon as possible. Despite the significant therapeutic advancements including the availability of anti-inflammatory therapy, many patients with psoriatic arthritis, particularly women, experience a substantial disease burden, and a patient-centric approach is highly warranted.

Depression often goes underdiagnosed and undertreated in individuals with psoriatic disease, resulting in detrimental impacts on their quality of life, disease management, and treatment adherence. The implementation of routine screening for depressive symptoms and enhancing access to mental health services to facilitate early diagnosis and concurrent treatment of depression is highly recommended.

References

  1. Frede N, Hiestand S, Schauer F, Endres D, Tebartz van Elst L, Zeisbrich M, et al. Psoriasis and Psoriatic Arthritis Have a Major Impact on Quality of Life and Depressive Symptoms: A Cross-Sectional Study of 300 Patients. Rheumatol Ther [Internet]. 2023 Oct 15 [cited 2023 Oct 26].
  2. Gondo G. c., Merola J. F., Bell S. J., Blauvelt A. Decreased quality of life in people with psoriasis and psoriatic arthritis vs. people with psoriasis alone: data from a national US survey. British Journal of Dermatology. 2021;185(6):1264–5.
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