PREVALENCE OF PSYCHIATRIC COMORBIDITIES IN PATIENTS WITH PSORIASIS AND THEIR EVOLUTION UNDER TREATMENT

Abstract

Psoriasis is a chronic, immune-mediated inflammatory dermatosis that associates a number of conditions such as cardiovascular disease, metabolic syndrome, inflammatory bowel disease, neoplasia or psychiatric disorders, amongst the most frequent being depression and anxiety. This article aims to highlight the common pathogenetic pathway between psoriasis and psychiatric comorbidities, depression and anxiety, their prevalence among psoriasis patients, as well as the evolution of these conditions under psoriasis-specific systemic therapy (biological therapy and conventional systemic therapy) using specific scales to quantify depression severity and anxiety (HAM-D, HAM-A), determined at a certain time interval after the initiation of therapies. We conducted an observational study in the Dermatology Department of the Slatina Emergency County Hospital on a group of 51 patients clinically diagnosed with psoriasis. Thus, we found that the degree of mental impairment in the studied group was significant, 49% of patients showed mild depression, 15.7% moderate depressive episodes and 5.9% severe depression. Only 29.4% were not affected by depression. In terms of anxiety, 21.6% had moderate anxiety. Psoriasis is a chronic condition associated with the secretion of numerous pro-inflammatory cytokines. Increased levels of pro-inflammatory cytokines are also found in major depressive disorders. Thus, the common pathogenic pathway between psoriasis and depression may be the overexpression of proinflammatory cytokines such as IL-6, IL-17 or TNF-α. In the last two decades, with the advent of biological therapies, the treatment of psoriasis has evolved dramatically, and they have also had a positive impact on comorbidities, particularly psychiatric ones.