A brief screening tool for depression in psoriasis patients: The Two Questions Test in clinical practice

Abstract

Psoriasis is a chronic inflammatory disease causing erythematous, scaly skin patches that are often itchy and painful. With a prevalence of around 2% in Western populations, it is among the most widespread skin conditions. 1,2 The pathological mechanisms are relatively well understood and effective systemic treatments to reduce skin symptoms have been developed. 3,4 However, a huge portion of psoriasis patients suffer from psychological comorbidities, foremost depressive symptoms. 5,6 Several factors are thought to underlie this connection between psoriasis and depression. On the one hand, the disabling symptoms have a significant impact on patients' quality of life and the easily visible plaques may lead to stigmatization and social withdrawal. 7 On the other hand, there is growing evidence that the peripheral systemic inflammation associated with psoriasis may facilitate the development of depression as well. 8

Discontinuation of Fumaric Acid Esters is Affected by Depressive Symptomatology: A Retrospective Analysis

“…Within the clinical routine, depressive symptoms were assessed using either the Two Questions Test (TQT [ 27 – 29 ]) or the Beck Depression Inventory II (BDI [ 30 ]). In the TQT, which is also known as the Whooley Questions, patients need to answer the following questions with yes or no: “Have you frequently felt dejected, sad, glum or hopeless during the past month?” and “Have you taken significantly less pleasure and joy in things, which you otherwise enjoy doing, over the past month?”.…”

“…This might have important implications for clinical practice. Psoriasis patients should be screened for the presence of depression as part of the clinical routine via their patient history and/or questionnaires, such as the TQT (27)(28)(29) or the BDI (30). If a depressive symptomatology is indicated, special attention to the prevention of AEs may be helpful in consultation with these patients, as there are several communication techniques that can help to minimize the occurrence of nocebo effects (43).…”