Patients with psoriasis have an increased risk for depression, anxiety, and somatoform disorders compared with individuals without psoriasis, according to study findings from a study published in the Journal of Dermatology.
Researchers analyzed outpatient and inpatient records from 1997 through 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 individuals 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 with 23.2 kg/m2 for the control group. The follow-up period was from 2003 to 2015.
The study authors found that patients with psoriasis had significantly higher rates of psychiatric diseases. The incidence rate of depression per 100,000 person-years was 408.3 for patients with psoriasis and 352.2 for the control individuals. For anxiety disorder, 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 for depression (hazard ratio [HR], 1.18; 95% CI, 1.09-1.26), 16% higher risk for anxiety disorders (HR, 1.16; 95% CI, 1.08-1.26), 21% increased risk for somatoform disorders (HR, 1.21; 95% CI, 1.08-1.34), and 18% increased risk for sleep disorders (HR, 1.18; 95% CI, 1.11-1.27), compared with control individuals.
Patients who had moderate to severe psoriasis had an increased risk for depression, anxiety disorders, somatoform disorders, and sleep disorders vs 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 sleep disorders, HR, 1.25; 95% CI, 1.06-1.47 vs HR, 1.17; 95% CI, 1.09-1.26.
Among several study limitations, the investigators noted the potential for misclassification of disease in the datasets, and diagnostic codes may not always be determined by certified dermatologists in Korea. Also, data regarding disease duration, family history, and objective scores of disease severity were not available, which prevented examination of possible variables that affect psychiatric diseases.
“Our data suggest that patients with psoriasis are more vulnerable to psychiatric diseases with the highest risk occurring among severe psoriasis patients,” stated the researchers. “Therefore, dermatologists should be aware of this and focus not only on their dermatological condition but also on their mental health.”
Oh J, Jung KJ, Kim T-G, et al. Risk of psychiatric diseases among patients with psoriasis in Korea: A 12-year nationwide population-based cohort study. J Dermatol. Published online August 30, 2021. doi:10.1111/1346-8138.16115