Ferreira Bárbara Roque, Pio-Abreu José Luís, Reis José Pedro, Figueiredo Américo
Department of Dermatology, Coimbra Hospital and University Centre, Coimbra, Portugal,
Psychiatr Danub. 2017 Dec;29(4):401-406. doi: 10.24869/psyd.2017.401.
The boundary between Dermatology and Psychiatry has increasing recognition. Psoriasis is a common psychophysiological skin disease with a major impact on patient's quality of life and a paradigmatic example of a pathology in that boundary. Studies are needed to exactly point out the prevalence of specific psychopathology and mental disorders associated with psoriasis. This work intends to analyse the prevalence of psychopathology and psychiatric comorbidities in patients with psoriasis.
A systematic review of the literature was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the "5S" model proposed by Haynes. From all the papers retrieved by this search, a total of 34 papers met the inclusion criteria and were then deeply analysed.
The most prevalent mental disorders in these patients are sleep disorders (average prevalence: 62.0%), sexual dysfunction (45.6%), personality (35.0%), anxiety (30.4%), adjustment (29.0%), depressive (27.6%) and substance-related and addictive disorders (24.8%). Other mental disorders have been less described, namely somatic symptoms and related disorders, schizophrenia and other psychoses, bipolar disorder and eating disorders.
This updated research shows that the prevalence of psychiatric conditions in psoriasis may range from 24% to 90%. The study of the mind-skin connection in psoriasis may improve the knowledge about psoriasis and its psychiatric comorbidities. The link between psoriasis and associated mental disorders is frequently forgotten or not considered in the clinical practice. Psychiatric disorders in patients with psoriasis may be underdiagnosed. These patients would really benefit from psychiatric assessment, with therapeutic relevance.
皮肤病学与精神病学之间的界限越来越受到认可。银屑病是一种常见的心理生理皮肤病，对患者的生活质量有重大影响，是该界限内一种典型的病理学范例。需要开展研究以准确指出与银屑病相关的特定精神病理学和精神障碍的患病率。本研究旨在分析银屑病患者中精神病理学和精神疾病共病的患病率。
按照系统评价和Meta分析的首选报告项目（PRISMA）以及海恩斯提出的“5S”模型对文献进行系统评价。在本次检索所获取的所有论文中，共有34篇论文符合纳入标准，随后对其进行深入分析。
这些患者中最常见的精神障碍是睡眠障碍（平均患病率：62.0%）、性功能障碍（45.6%）、人格障碍（35.0%）、焦虑症（30.4%）、适应障碍（29.0%）、抑郁症（27.6%）以及物质相关和成瘾性障碍（24.8%）。其他精神障碍的描述较少，即躯体症状及相关障碍、精神分裂症和其他精神病性障碍、双相情感障碍和进食障碍。
这项最新研究表明，银屑病患者中精神疾病的患病率可能在24%至90%之间。对银屑病中心 - 皮肤联系的研究可能会增进对银屑病及其精神疾病共病的了解。银屑病与相关精神障碍之间的联系在临床实践中常常被遗忘或未被考虑。银屑病患者的精神障碍可能未得到充分诊断。这些患者将真正受益于具有治疗意义的精神科评估。
