Association of Psoriasis With Anxiety and Depression: A Case-Control Study in Chinese Patients.

Danrong Jing,Xi Han,Yehong Kuang,Xiang Chen,Wu Zhu,Yi Xiao,Minxue Shen,Hui Xiao

doi:10.3389/fmed.2021.771645

Danrong Jing, Xi Han + Show 6 more

Open Access

https://doi.org/10.3389/fmed.2021.771645

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Abstract

Background: Patients with psoriasis are prone to suffer from anxiety and depression during their lifetime. This study aimed to investigate the association of psoriasis with anxiety and depression in Chinese patients.Methods: A case-control study in Chinese patients with psoriasis vulgaris and healthy controls was conducted. Clinical information based on patient-reported, clinical information, and reliable structured questionnaires were collected. Multivariable logistic regression was used to investigate the associations, in terms of adjusted odds ratios (AORs).Results: We continuously selected 1,571 patients who were firstly diagnosed with psoriasis vulgaris, and 1,571 healthy controls, matched by age and sex. The risk of depression in the psoriasis vulgaris group was higher than that in the healthy controls (AOR = 1.30, P = 0.047), while no differences were found in the risk of anxiety between the two groups (AOR = 1.18, P = 0.381). Subgroup analysis by disease onsets showed that late-onset psoriasis (LOP) was significantly associated with a higher risk of anxiety (AOR = 1.47, P = 0.033) and depression symptoms (AOR = 1.85, P = 0.012) but not with early-onset psoriasis (EOP). Subgroup analysis by disease severity indicated that no difference was observed in the associations of mild psoriasis vulgaris, moderate-to-severe psoriasis vulgaris with anxiety and depression.Conclusion: Patients with psoriasis vulgaris were more likely to develop depression compared with the general population. LOP patients were positively associated with anxiety and depression. We believe the screening of emotional disorders should be included in the daily management of psoriasis patients.

Highlights

Psoriasis is a chronic inflammatory skin disease associated with several medical comorbidities such as psychosocial disorders, psoriatic arthritis, and cardiometabolic syndrome [1]
The patients were divided into two groups according to their disease severity based on the Psoriasis Area and Severity Index (PASI): PASI score
The proportion of education level, annual income and smoking status was significantly higher among healthy control subjects compared to those with psoriasis patients (P < 0.001)

Summary

Introduction

Psoriasis is a chronic inflammatory skin disease associated with several medical comorbidities such as psychosocial disorders, psoriatic arthritis, and cardiometabolic syndrome [1]. Psoriatic lesions usually occurred in the visible skin areas involved the scalp, limbs, and extensor surfaces such as the elbows and knees [5]. Previous reports found early-onset psoriasis (EOP), meaning first presented psoriatic lesions at and prior to the age of 40 years, comprises approximately 70% of all psoriasis. Late-onset psoriasis (LOP), which presents after 40 years old [7, 8]. Patients with EOP were more likely to have a family history, more extensive body surface involvement, and strongly associated with HLA-C∗06, while patients with LOP tend to be sporadic, accompanied with numerous complications, such as diabetes, high blood pressure, dyslipidemia, and obesity [9]. This study aimed to investigate the association of psoriasis with anxiety and depression in Chinese patients

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