Depression Rates Almost Double For Individuals With Psoriasis History
Researchers are calling for all individuals with a history of psoriasis to be screened for depression after an analysis of a national base found the autoimmune disease is linked with twice the risk of depression.
According to the data presented at the American Academy of Dermatology summer meeting, approximately 16.5% of individuals with a history of psoriasis also experienced depression. In comparison, only 8.9% of individuals without a psoriasis history experienced depression.
The researchers note severity of psoriasis did not significantly influence the likelihood of depression.
Individuals with psoriasis and a history of cardiovascular events faced an even higher rate of depression, however researchers reported a positive history of stroke or myocardial infarction (MI) did not influence the depression risk associated with psoriasis.
“This is a quality-of-life issue,” Roger S. Ho, MD, of NYU Langone Medical Center in New York City, told MedPage Today. “It is important for dermatologists and other medical providers to be aware of this association between psoriasis and depression, such that they can counsel their patients appropriately and to foster compliance with psoriasis medication, as well as early detection and medical intervention for any depressive symptoms.”
Ho also said dermatologists and other non-mental health professionals can screen for depression in psoriasis patients with the two-question PHQ2 depression survey.
Past research has established an association between psoriasis and psychiatric morbidity, including depression, anxiety, and substance abuse. There is also evidence indicating individuals with psoriasis have an increased risk of depression and suicidal ideation compared to healthy individuals.
The increased risk has caused Ho to urge for early identification of depression in individuals with psoriasis as depression can impair quality of life and risk of mortality. Already identified risk factors for depression and psoriasis have received little attention in medical journals and research has had conflicting result.
The relationship between depression and psoriasis is further complicated as both conditions are associated with a history of cardiovascular events.
In their attempt to shed light on the exact relationship between psoriasis and depression, the team of researchers analyzed data drawn from the National Health and Nutrition Examination Survey (NHANES) between 2009 and 2012. The data was collected from a representative sample of households in the U.S., and included 12,382 adults, of which 351 (2.83%) reported a history of psoriasis.
The NHANES survey included the nine-question PHQ9 depression questionnaire, which asked respondents to rate each item on the questionnaire from 0 to 3. Individuals with a total score over 10 were classified as depressed for the study.
Using this test, the survey found individuals with a history of psoriasis had nearly twice the rate of depression compared to those without a history of psoriasis, but severity of psoriasis did not significantly influence the chance of depression.
The survey also showed individuals with a history of psoriasis faced a significantly greater risk of coronary artery disease and MI. Both MI and stroke increased the risk of depression, but analysis showed that neither type of cardiovascular event altered the relationship between depression and psoriasis.
The limited number of participants with both a history of psoriasis and MI or stroke may have influenced the results.
“To our knowledge, this is the first study examining such adjusted association between psoriasis and depression in a cohort representative of the U.S. population,” Ho and colleagues concluded.