Understanding Psoriasis as a Biobehavioral Network Disease

Abstract

Psoriasis is a common immune-mediated inflammatory disease that can often be associated with psychiatric problems such as depression and anxiety. Although psychiatric disorders were initially considered secondary, the high prevalence suggests that common pathophysiological mechanisms may be involved in the development of psoriasis and psychiatric disorders. The shared neuroendocrine and immune mediators weave a web of networks with bidirectional pathways. Biopsychosocial patterns of psoriasis include psychological and behavioral consequences influencing personal social networks, psychological dispositions, and brain-skin psychoimmunological network patterns, which sums in a network of networks. The pathodynamics of other organ diseases like diabetes, liver diseases, internal organ tumors, and latent long-term inflammatory processes (chronic tonsillitis, prostatitis, abscesses and inflammations in the gums, chronic sinusitis) influence psoriasis. Vice versa, psoriasis might cause a pathological impact on other organ systems via networked connections, like arthritis or psychological dispositions. Treatment of psoriasis needs networking through the cooperation of dermatology, rheumatology, and psychiatry and by combining different therapies.