Psoriasis Patients Have Increased Risk Of Depression

Roger S. Ho, MD, MS, MPH, FAAD Assistant Professor The Ronald O. Perelman Department of Dermatology NYU Langone Medical Interview with:
Roger S. Ho, MD, MS, MPH, FAAD
Assistant Professor
The Ronald O. Perelman Department of Dermatology
NYU Langone Medical Center

Medical Research: What is the background for this study? What are the main findings?

Dr. Ho: In recent years, the impact of psoriasis on quality of life has come to light. We have seen several studies show that patients with psoriasis experience worse quality of life because of their disease. Few studies however have examined the association between psoriasis and mental illness, specifically depression. Many chronic diseases are known to be associated with depression. As more and more evidence supports the relationship between psoriasis and cardiovascular disease, it is important to examine the relationship between psoriasis and depression, while controlling for cardiovascular comorbidity.

In our study of a nationally-representative population of US patients, we found that patients with psoriasis had twice the odds of having depression than patients without psoriasis, even after adjusting for major confounders including a history of myocardial infarction, stroke, and diabetes that may independently be associated with depression. The risk of depression did not depend on extent or severity of psoriatic disease.

Medical Research: What should clinicians and patients take away from your report?

Dr. Ho: This study demonstrates that patients with psoriasis, a treatable medical condition, are at increased risk for depression.   Ultimately, this is a quality of life issue.  Dermatologists and all clinicians who may encounter patients with psoriasis should be aware of this increased risk for depression, independent of disease severity and comorbidities, such that they can counsel psoriasis patients of this relationship appropriately and to foster compliance of psoriasis therapies.

It is also important for patients to be aware of this risk in order to encourage patients to report depressive symptoms and to seek help early on in their disease course.   Early treatment of depression and psoriasis in these patients may help to improve these patients’ quality of life.

Finally, many times, patients themselves might not be cognizant of their own depression symptoms.   Our findings suggest that clinicians should screen all patients with psoriasis, regardless of disease severity, for depression symptoms in order to provide timely detection and management of the patient’s possible depression.  Family and friends of psoriasis patients should also learn of this relationship between psoriasis and depression as they, too, can help recognize symptoms of depression and encourage proper psoriasis and depression treatments.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Ho: While our study demonstrates that patients with psoriasis are at increased risk for depression, being a cross-sectional study, it does not prove causality.  As a result, more epidemiological studies are warranted to fully investigate this relationship and the science behind it.  Although the public’s stigmatization of this visible disease might be one of the factors in play driving the relationship, I think there may be other genetic and biologic factors that we are not aware of yet.  Psoriasis, after all, is a disease of an overactive immune system.  It will definitely be interesting to see more basic science research as well to examine this relationship, with a particular focus in the interaction between the mediators from our immune system that drive psoriasis and the bio-psychiatric state of our nervous system that drive major depression.


2015 Summer AAD presentation discussing:

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Roger S. Ho, MD, MS, MPH, FAAD (2015). Psoriasis Patients Have Increased Risk Of Depression

Last Updated on August 26, 2015 by Marie Benz MD FAAD