Neuropsychiatric comorbidity among adolescents with psoriasis

Abstract

Psoriasis is a known risk factor for neuropsychiatric diseases among adults. Less is known about the impact on adolescents. To investigate the association between psoriasis and neuropsychiatric comorbidity and social skills among adolescents. A population-based cross-sectional study between 1 January 1999 and 1 January 2014 was conducted. The study included 1746 and 1366 adolescents (aged 16 to 18) with mild and moderate-to-severe psoriasis, respectively. The psoriasis patients were diagnosed by a dermatologist. Neuropsychiatric diseases were diagnosed by a neurologist and a psychiatrist, as appropriate. Social skills were evaluated using psychosocial assessment. Patients with psoriasis were compared with 884 653 healthy controls by a multivariate analysis adjusted for age, sex, country of origin, socioeconomic status, cognitive skills and body mass index. A subgroup evaluation was done for comorbidity that could only be evaluated for part of the recruitment years, using a univariate analysis. Overall chronic headaches (8·1% vs. 3·4%), intermediate frequency migraine (4·8% vs. 1·6%), low-frequency migraine and nonmigraine headaches (3·4% vs. 1·8%) were associated with moderate-to-severe psoriasis only compared with healthy controls [adjusted odds ratios (OR) 1·9, 95% confidence interval (CI) 1·6-2·4; 2·3, 95% CI 1·8-3·0 and 1·5, 95% CI 1·1-2·1, respectively]. Anxiety disorders (2·1% vs. 0·8%) and impaired social adjustment skills (7·5% vs. 4·2%) were also associated with moderate-to-severe psoriasis only compared with healthy controls [adjusted ORs 2·9, 95% CI 1·6-5·5 and 1·9, 95% CI 1·3-2·6 (of 466 vs. 265 023), respectively]. Psoriasis among adolescents is associated with neuropsychiatric comorbidity and impaired adjustment skills, depending on disease severity.