Clinical Edge

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

Psoriasis Independently Linked with Depression Risk

Br J Dermatol; 2019 Jan; Egeberg, Thyssen, Wu, et al

Psoriasis was independently associated with risk of depression, a recent study found. These results, therefore, may help clinicians identify particularly high‐risk individuals. Researchers used individual‐level linkage of national administrative registers. Patients with psoriasis aged ≥18 years between January 1, 1997, and December 31, 2016, were matched 1:1 with individuals without psoriasis. They found:

  • There were 247,755 patients with psoriasis: 220,721 were treated with topicals (mild psoriasis), 24,771 with systemic non-biologics (moderate psoriasis), and 2,263 with biological therapy (severe psoriasis).
  • The same number of matched referents without psoriasis were also analyzed.
  • During a maximum 20 years of follow‐up, 45,641 patients with psoriasis and 36,299 referents developed depression.
  • In adjusted models, the HRs of depression were 1.19 (1.17–1.20), 1.19 (1.15–1.23), and 1.50 (1.23–1.84) for mild, moderate, and severe psoriasis, respectively.
  • The highest risk was observed among patients with severe psoriasis aged 40–50 years.
  • The incidence of depression was markedly higher among patients with previous depression.

Citation:

Egeberg A, Thyssen JP, Wu JJ, Skov L. Risk of first-time and recurrent depression in patients with psoriasis: A population-based cohort study. Br J Dermatol. 2019;180(1):116-121. doi:10.1111/bjd.17208.

Commentary:

Since psoriasis is a visible and symptomatic condition, it is not surprising that it has been independently associated with an increased incidence of depression. Several studies have confirmed depression and increased suicide rates, as well as suicidal ideation, as a substantial comorbidity with psoriasis. This study demonstrated that the highest risk for depression among patients with psoriasis was among middle-aged patients with severe psoriasis who have a history of depression. If depression is suspected in a patient with psoriasis, then referring them to therapist can lead to improved outcomes.—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.

This Week's Must Reads

Health Care Screening, Skin Cancer Risk Link Found, JAMA Dermatology; ePub 2018 Dec 26; Drucker, et al

Vitamin D Linked with Eczema in Non-Hispanic Whites, Allergy; ePub 2018 Dec 27; Wei, Jaleel, et al

Mohs Surgery Beneficial for Melanoma of Head/Neck, Dermatolog Surg; ePub 2018 Dec 13; Demer, et al

Study: Vitiligo and Major Depression Disorder Linked, J Am Acad Dermatol; ePub 2018 Dec 5; Vallerand, et al

Habitual Nail Biting, Psychiatric Disorders Linked , Am J Clin Dermatol; 2018 Dec; Winebrake, et al

Must Reads in Psoriasis

Psoriasis Linked with Increased All-Cause Mortality, J Am Acad Dermatol; ePub 2018 Dec 24; Dhana, et al

Examining Patient Resistance to Psoriasis Treatment, Exp Opin Pharmacother; ePub 2018 Dec 27; Heath, et al

Psoriasis Linked with Periodontal Inflammation, J Invest Dermatol; ePub 2019 Jan 2; Woeste, et al

Psoriasis Independently Linked with Depression Risk, Br J Dermatol; 2019 Jan; Egeberg, Thyssen, Wu, et al

Health Literacy May Benefit Patients with Psoriasis, Br J Dermatol; ePub 2018 Dec 31; Larsen, et al