Wu J J, Feldman S R, Koo J, Marangell L B
a Kaiser Permanente Los Angeles Medical Center , Los Angeles , CA , USA.
b Wake Forest University School of Medicine , Winston-Salem , NC , USA.
J Dermatolog Treat. 2018 Aug;29(5):487-495. doi: 10.1080/09546634.2017.1395800. Epub 2017 Nov 10.
The occurrence of mental health comorbidities such as depression, anxiety, and suicidal ideation or behavior is not uncommon in the context of psoriasis. The negative influence of psoriatic disease on a patient's physical and mental well-being, in combination with overlapping pathophysiology, increase the risk for clinically significant psychiatric conditions. These psychiatric conditions, in turn, influence the patient's outlook and potentially, prognosis. Although the healthcare community increasingly recognizes the association of mental health comorbidities with psoriasis, the extent of the correlation is not fully appreciated. To better understand the relationship between mental health comorbidities and psoriasis, including prevalence, risk factors, and response of psychiatric comorbidities to psoriasis treatment, a narrative review of the published literature was conducted.
Data from epidemiologic, observational, and clinical studies demonstrate a substantially greater mental health comorbidity burden in patients with psoriasis compared with those without psoriasis or patients with other dermatologic conditions.
The influence of contemporary drug therapies on measures of depression and anxiety are predominantly positive, although further data are needed to better understand the effects of long-term therapy.
Clinicians should consider the heightened potential for mental health comorbidities when determining an optimal management strategy for their patients with psoriasis.
在银屑病患者中，抑郁症、焦虑症以及自杀观念或行为等心理健康共病的情况并不罕见。银屑病对患者身心健康的负面影响，加之重叠的病理生理学机制，增加了出现具有临床意义的精神疾病的风险。而这些精神疾病反过来又会影响患者的前景乃至预后。尽管医疗界越来越认识到心理健康共病与银屑病之间的关联，但这种相关性的程度尚未得到充分认识。为了更好地理解心理健康共病与银屑病之间的关系，包括患病率、风险因素以及精神共病对银屑病治疗的反应，我们对已发表的文献进行了叙述性综述。
来自流行病学、观察性和临床研究的数据表明，与无银屑病患者或其他皮肤病患者相比，银屑病患者的心理健康共病负担要大得多。
当代药物疗法对抑郁和焦虑指标的影响主要是积极的，不过还需要更多数据来更好地了解长期治疗的效果。
临床医生在为银屑病患者确定最佳管理策略时，应考虑到其心理健康共病的可能性增加。
