Depression and Suicidality in Patients With Psoriasis and the Role of Psoriatic Arthritis: A Cross-sectional Study in a Tertiary Setting

Lada, Georgia; Chinoy, Hector; Heal, Calvin; Warren, Richard B.; Talbot, Peter S.; Kleyn, C. Elise

doi:10.1016/j.jaclp.2021.12.007

Cited by 14 publications

(32 citation statements)

References 47 publications

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“…We found that patients with both skin and MSK manifestations had higher HADS anxiety and depression scores. Lada et al [ 26 ] concluded that highlight the increased depressive burden among psoriasis patients with PsA compared to those without PsA.…”

Section: Discussionmentioning

confidence: 99%

Serum interleukin-23 levels: relation to depression, anxiety, and disease activity in psoriatic arthritis patients

et al. 2022

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Objectives Assessment of serum levels of IL-23 in PsA patients and its correlation with depression, anxiety, and disease activity. Methods Eighty psoriatic arthritis (PsA) patients and eighty healthy volunteers matched for age and gender were included in this observational case–control study. All participants suspected to detailed history, clinical assessment, PsA activity using Disease Activity Index for Psoriatic Arthritis (DAPSA) score, the severity and extent of psoriasis was assessed by the Psoriasis Area and Severity Index (PASI), and ultrasonographic assessments of the entheses were examined according to the Madrid Sonographic Enthesitis Index (MASEI). Depression and anxiety were assessed by Hospital Anxiety and Depression Scale (HADS). Serum IL-23 was measured and correlated with disease activity, depression, and anxiety. Results There was no significant difference between patients and controls regarding demographic data. Thirty-six PsA patients (45%) had anxiety and 28 patients (35%) had depression, while in the control group, 16 persons (20%) had anxiety and 12 (15%) had depression, with significant differences between the 2 groups (p < 0.0001). There were significant differences in HADS anxiety and depression scores between patients and controls with significant positive correlations between HADS depression, anxiety scores and IL-23, DAPSA, PASI, and MASEI scores (p < 0.05). IL-23 was positively correlated with DAPSA, PASI, and HADS scores; we observed that interleukin 23, higher DAPSA, and PASI were independently associated with depression and anxiety. Conclusion Serum interleukin-23 levels were elevated in PsA patients and were found to be correlated with depression, anxiety, and disease activity. Key Points• Psoriatic arthritis is a multidimensional disorder with psychiatric drawbacks.• Interleukin-23 is a proinflammatory cytokines that was correlated with depression and anxiety in PsA patients.• Interleukin-23 was correlated with disease activity in PsA.• Depression and anxiety were positively correlated with disease activity in PsA.

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Section: Discussionmentioning

confidence: 99%

Serum interleukin-23 levels: relation to depression, anxiety, and disease activity in psoriatic arthritis patients

et al. 2022

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“…Data were collected as part of a pre‐existing survey assessing mental health in patients with psoriasis; this study was initiated before the Covid‐19 pandemic and its recruitment and methods have been previously described in detail. 12 Briefly, patients were recruited from our tertiary Greater Manchester psoriasis and psoriatic arthritis clinics and were eligible provided they had: age of 18–65 years, a dermatologist‐confirmed diagnosis of chronic plaque psoriasis, capacity and willingness to give informed consent, and registration with a general practitioner (GP). We excluded patients who had significant neurocognitive impairment or insufficient command of the English language.…”

Section: Methodsmentioning

confidence: 99%

“…We made every effort to include and assist participants with questionnaire completion and clarifications, where appropriate. 12 …”

Section: Methodsmentioning

confidence: 99%

“…We made every effort to include and assist participants with questionnaire completion and clarifications, where appropriate. 12 A first group of participants had enroled in this preexisting study before the first Covid-19 lockdown initiated in March 2020 in England (September 2019-February 2020). 12 Patients completed the Brief-Illness Perceptions Questionnaire (BIPQ) adapted for psoriasis, which is a validated measure assessing eight perception domains.…”

Section: Procedures and Participantsmentioning

confidence: 99%

“…12 A first group of participants had enroled in this preexisting study before the first Covid-19 lockdown initiated in March 2020 in England (September 2019-February 2020). 12 Patients completed the Brief-Illness Perceptions Questionnaire (BIPQ) adapted for psoriasis, which is a validated measure assessing eight perception domains. 13 The presence of depression was assessed using the Hospital Anxiety and Depression Scale (HADS) 14 ; psoriasis-related quality of life was assessed with the Dermatology Life Quality Index (DLQI).…”

Section: Procedures and Participantsmentioning

confidence: 99%

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The effect of the Covid‐19 pandemic on illness perceptions of psoriasis and the role of depression: Findings from a cross‐sectional study

Lada

Chinoy

Talbot

et al. 2022

Skin Health and Disease

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Background Illness perceptions in psoriasis have an impact on adherence and disability. Changes in dermatological healthcare provision during the Covid‐19 pandemic and distress may have affected illness perceptions in psoriasis patients. Objectives To test whether illness perceptions about psoriasis changed during the first year of the Covid‐19 pandemic compared to pre‐pandemic in a tertiary population with psoriasis and whether pandemic effects differed depending on depressive burden, given this population's high depression prevalence. Methods In a cross‐sectional survey of n = 188 tertiary patients with dermatologist‐confirmed psoriasis recruited before and during the pandemic, eight illness perceptions domains were assessed using the Brief‐Illness Perceptions Questionnaire (BIPQ). Presence of depression was assessed with the Hospital Anxiety and Depression Scale (HADS). Results Beliefs about treatment control and patients' understanding of psoriasis were significantly worse in patients responding during the pandemic compared to before Covid‐19. These differences were greater when depression was absent (treatment control: adjusted p < 0.001; coherence: adjusted p = 0.01). However, participants during the pandemic felt less emotionally affected (adjusted p = 0.02) and concerned (adjusted p = 0.007) about psoriasis, independently of depression. Conclusions We found diverse pandemic effects on illness perception domains in psoriasis. Uncertainty and reduced healthcare access may drive poorer treatment and coherence beliefs during Covid‐19. These beliefs can hinder patients' health‐promoting behaviours and may explain the high pandemic non‐adherence reported previously in psoriasis. Appropriate interventions are needed to establish positive long‐term cognitions and improve psoriasis management, for example, using the PsoWell patient materials. Dermatology services should invest in engaging and educating patients regardless of concurrent psychological distress.

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Assessing the burden of patients with psoriasis through the concept of cumulative life course impairment: A narrative literature review

Crochard

Gherardi

Kollen

et al. 2023

JEADV Clinical Practice

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Psoriasis can affect diverse facets of patients' lives over time and may lead to irreversible cumulative life course impairment (CLCI). The CLCI concept initially described in 2010 in the context of psoriasis encompasses the intricate interaction between physical, psychological, social and economic burden and is influenced by several factors such as coping mechanisms, personality and external factors. CLCI assessment is conducted to characterise and ultimately mitigate or prevent the patient's burden over the life course. This review aims to give a comprehensive overview of the development and use of the CLCI concept in psoriasis since its inception. A narrative literature review was conducted from 2010 to 2022 and included 19 publications. As original studies on CLCI are scarce, this review primarily relied on case studies and those without longitudinal assessment. The core components of CLCI burden identified in patients' narratives include physical impairment, psychological impairment, stigma, socioeconomic burden and modulating factors. Modulating factors are crucial to mitigate the burden but are not equally explored. The burden associated with psoriasis stands across all dimensions covered by CLCI, thus confirming its suitability in clinical management and future studies. A better understanding of CLCI can support physicians and researchers in improving patients' lives and raising awareness on the necessity to develop early, efficient and patient‐centric interventions. The practical and systematic adoption of CLCI yet relies on the development and psychometric validation of a questionnaire that measures it.

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Depression and Suicidality in Patients With Psoriasis and the Role of Psoriatic Arthritis: A Cross-sectional Study in a Tertiary Setting

Cited by 14 publications

References 47 publications

Serum interleukin-23 levels: relation to depression, anxiety, and disease activity in psoriatic arthritis patients

Serum interleukin-23 levels: relation to depression, anxiety, and disease activity in psoriatic arthritis patients

The effect of the Covid‐19 pandemic on illness perceptions of psoriasis and the role of depression: Findings from a cross‐sectional study

Assessing the burden of patients with psoriasis through the concept of cumulative life course impairment: A narrative literature review

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