AB0739 THE PREVALENCE OF PSYCHOLOGICAL DISORDERS IN PATIENTSWITH SEVERE PSORIASIS WITH/WITHOUT PSORIATIC ARTHRITIS IN CLINICAL PRACTICE: DATA FROM A SINGLE DERMATOLOGICAL SETTING

Abstract

Background Psoriatic arthritis (PsA) and Psoriasis (PsO) are associated with different psychological disorders. Depression is a risk factor for development of PsA among PsO patients (pts). Diagnosis of PsA in dermatological practice is still problematic. The prevalence of psychological disorders in patients with severe PsO with/without PsA are limited in the Russian Federation. Objectives To study the prevalence of anxiety, depression and fatigue in pts with severe PsO with/without PsA in a single dermatological setting. Methods 99 unselected pts (male-23/female-76) with severe plaque PsO, mean age 45.82±14.04 years, BSA 56.35±9.11%, PASI 22.50 ± 5.13 were included. PsA was diagnosed by the CASPAR criteria. Anxiety, depression and fatigue were identified by the Hospital anxiety Scale (HADS-A), HADS-Depression (HADS-D) and Functional assessment of Chronic Illness therapy (FACIT) (points) accordingly. The HADS-A/HADS-D was defined as normal - 0-7; presence of disorders - 8-10; psychiatric morbidity >11 points accordingly. FACIT 43.6±9.4 matched with healthy control. The lower the level of FACIT corresponded to higher fatigue. The number of pts with FACIT≤30 were calculated. All pts were treated with different synthetic DMARDs, mostly Methotrexate (subcutaneous 15-20 mg every week), biological DMARDs according local therapy according to the national guidelines. M±m,%, chi², t-test were performed. All p Results 20 out of 99 pts (20.2%) had PsA. In all group mean HADS-D/HADS-A/FACIT were 2.59±3.88/4.61±6.54/41.47±6.41 accordingly. In PsO pts without PsA presence of disorders/psychiatric morbidity by HADS-A were seen in significantly more cases compare to PsO pts with PsA: totally in 30 out of 79 pts (38%)/in 2 out of 20 pts (10%) accordingly (chi2, p=0.025). In PsO pts without/with PsA presence of disorders/psychiatric morbidity by HADS-D were seen totally in 20 out of 79 pts (25.3%)/in 2 out of 20 pts (10%) accordingly (chi2, p=0.24). No significant difference were found between groups. In PsO pts without/with PsA FACIT≤30 were seen in 2 out of 79 pts (2.53%)/in 2 out of 20 pts (10%). No significant difference were found between groups (chi2, p=0.17). Conclusion In our real dermatological clinical practice cohort of pts with severe PsO subclinical and clinical anxiety and depression were detected in about 30% of cases. This fact should be taken into account for the early detection of pts at risk for developing PsA.