Patients with psoriasis are at increased risk of depression, anxiety, and somatoform disorders compared to those without psoriasis, according to a study published in the Journal of Dermatology.
The researchers analyzed outpatient and inpatient records from 1997 to 2015 from the Korean Cancer Prevention Study (KCPS) cohort provided by the National Health Insurance System (NHIS).
The study included 10,868 patients with psoriasis (mean age 44.0 years) and 1,620,055 people without psoriasis (mean age 43.3 years) from the general population. Patients with psoriasis had a mean body mass index of 23.4 kg / m2 compared to 23.2 kg / m2 in the control group. The follow-up period extended from 2003 to 2015.
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The study authors found that patients with psoriasis had significantly higher rates of psychiatric illness. The incidence of depression per 100,000 person-years was 408.3 in patients with psoriasis and 352.2 in controls. For anxiety disorders, the incidence rate per 100,000 person-years was 426.9 in the psoriasis group and 371.3 in the control group.
According to Cox proportional hazard models, patients with psoriasis had an 18% increased risk of depression (hazard ratio [HR], 1.18; 95% CI 1.09-1.26, 16% higher risk of anxiety disorders (HR 1.16; 95% CI 1.08-1.26), 21% increased risk of somatoform disorders (HR 1.21; 95% CI 1.08-1.34) and an 18% increased risk of sleep disorders (HR 1.18; 95% CI: 1.11-1.27) compared to control persons.
Patients with moderate to severe psoriasis were at increased risk for depression, anxiety disorders, somatoform disorders, and sleep disorders compared to patients with mild psoriasis – depression, HR 1.28; 95% CI 1.07-1.54 vs. HR 1.17; 95% CI 1.07-1.27; Anxiety Disorders, HR, 1.24; 95% CI 1.04-1.49 vs. HR 1.15; 95% CI 1.06-1.25; somatoform disorders, HR, 1.60; 95% CI 1.26-2.03 vs. HR 1.13; 95% CI, 1.00-1.28; and insomnia, HR, 1.25; 95% CI 1.06-1.47 vs. HR 1.17; 95% CI, 1.09-1.26.
Under several caveats in the study, researchers pointed out the possibility of disease misclassification in the datasets and diagnostic codes may not always be determined by certified dermatologists in Korea. Data on the duration of the illness, family history, and objective degrees of severity of the illness were also not available, which prevented an examination of possible variables that influence psychiatric illnesses.
“Our data suggest that patients with psoriasis are more prone to psychiatric illness, with the highest risk occurring in those with severe psoriasis,” the researchers said. “Therefore, dermatologists should be aware of this and focus not only on their dermatological condition, but also on their mental health.”
reference
Oh J, Jung KJ, Kim TG, et al. Risk of Psychiatric Disease in Patients with Psoriasis in Korea: A 12-Year Nationwide Population-Based Cohort Study. J Dermacol. Published online August 30, 2021. doi: 10.1111 / 1346-8138.16115
This article originally appeared on Dermatology Advisor
