Two questions may be enough - screening for depression in patients with psoriasis: a multicenter study.

Abstract

Depression is frequently underdiagnosed and insufficiently treated in psoriatic patients in their daily routine. The aim of this study was to screen and analyze the impact of patient and disease characteristics on depression scores. In this cross-sectional multicenter cohort study, adult psoriasis patients were screened for depression with two validated tools: the Whooley questions and the revised Beck Depression Inventory (BDI-II). Overall, 538 patients (median PASI 3.0, mean DLQI 5.3) were screened for depressive symptoms (mean BDI-II score 8.3). 24.2% of all participants reached a BDI-II score ≥13, suggesting a depression that was at least mild. The results of the Whooley questions were positive for 28.2% of the patients. There was a strong correlation between the two tools (p<0.001). In the subgroup with a BDI-II score ≥13, disease activity (median PASI 3.8 vs. 2.8, p=0.06) and DLQI scores (mean 10.1 vs. 3.7, p<0.0001) were higher, and psoriatic arthritis and diabetes were more prevalent (52.6% vs. 37.8%, p=0.002, and 16.2% vs. 10.0%, p=0.04, respectively) than in the subgroup with a BDI-II score <13. In specialized psoriatic outpatient clinics, a BDI-II score ≥13 was present in almost every fourth patient despite a low median PASI. The Whooley questions might be easy to use as a screening tool for depression in psoriasis patients.