Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Psoriasis and Risk of Mental Disorders

There is a higher risk of both depression and bipolar disorder among patients with psoriasis, a new study found. Researchers used data from population-based registries covering all Danish hospitals to identify individuals born from 1900 - 1995 who had ≥2 hospital- or outpatient-based diagnoses of psoriasis from January 1, 1977, to January 1, 2012. Researchers found:

  • 13,675 individuals with psoriasis were identified.
  • The 5- and 10-year cumulative incidences of any mental disorder were 2.6% and 4.9%, respectively.
  • The hazard ratio (HR) of any mental disorder was 1.75 when comparing those with psoriasis with the general population cohort.
  • The HRs for selected mental disorders were as follows: 1.73 for vascular dementia, 1.64 for schizophrenia, 2.33 for bipolar disorder, 1.72 for unipolar depression, 1.88 for generalized anxiety disorder, and 2.06 for personality disorders.

Citation:

Leisner MZ, Riis JL, Schwartz S, Iversen L, Østergaard SD, Olsen MS. Psoriasis and risk of mental disorders in Denmark. [Published online ahead of print May 8, 2019]. JAMA Dermatol. doi:10.1001/jamadermatol.2019.0039.

Commentary:

The association between mental disorders such as depression and anxiety has been established from several studies. These findings are in agreement with those of previous research, indicating a higher risk of mental disorders among those with psoriasis compared to the control population. This report emphasizes the need for an approach when treating individuals with psoriasis to focus not only on their dermatologic condition but also to address mental health issues that may be present. This would involve co-management of the dermatologist together with a mental health specialist to optimize outcomes in patients with psoriasis. —Paul S. Yamauchi, MD, PhD; Clinical Assistant Professor of Dermatology David Geffen School of Medicine at UCLA; Harbor-UCLA Medical Center Division of Dermatology; Adjunct Associate Professor John Wayne Cancer Institute.