Advancing Knowledge. Enhancing Care.
Advancing Knowledge. Enhancing Care.

Psoriasis News

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EADV 2020 | Psychological Burden of Psoriasis

Quality of life 2020

Presented by Dimitrios Ioannides, MD, PhD

A report from the 29th Congress of the European Academy of Dermatology and Venereology

Psoriasis is a major global health problem and has an immense impact on patients’ lives. Unfortunately, many patients suffer needlessly due to delayed diagnosis, delayed treatment, or under-treatment.11

Increasingly, studies have demonstrated the negative psychological impact of psoriasis. Most psoriasis patients experience stigmatization, discrimination, and humiliation, and the emotional impact is not always proportional to disease extent. In addition to negative self-perception, defined psychiatric diagnoses are more prevalent in psoriasis patients.12-14

A large meta-analysis found that over half of patients suffer from some diagnoseable psychiatric disorder,15 and a case-controlled study identified a bidirectional association between psoriasis and depression.16 Another study found significant increase in relative risk (RR) for depression (1.39), anxiety (1.21), and suicidality (1.44), with depression RR higher in severe (1.72) compared to mild (1.38) psoriasis. Moreover, younger patients seem to be more affected.17

Interestingly, psoriatic skin lesions are not the only factor in depression; the ‘inflammatory state’ of psoriasis also contributes directly. Pro-inflammatory cytokines cause changes in neurotransmitter signaling,18 and shared psoriasis/depression cytokines such as IFN-a and IL-2 induce enzymatic degradation of tryptophan, a serotonin precursor. Furthermore, these tryptophan catabolites can independently induce depression and anxiety.19

Early detection of depression can be reliably achieved through short, effective screening techniques,20,21 and prompt effective treatment may prevent depressive symptoms.22 Dr. Ioannides stressed that integrated, comprehensive treatment for our patients is necessary to improve all facets of their lives.

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