Department of Psychiatry, University of Granada, Granada, Spain; CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain.
Dermatology Service, Virgen de la Nieves University Hospital, Granada, Spain.
J Psychosom Res. 2019 Sep;124:109780. doi: 10.1016/j.jpsychores.2019.109780. Epub 2019 Jul 18.
To compare quality of life (QoL), anxiety and depressive symptoms, alcohol consumption and other correlates between patients with psoriasis and controls; and to identify features of psoriasis associated with lower levels of QoL.
Case-control study including 70 subjects with moderate-severe psoriasis and 140 controls without psoriasis. All participants answered the Short Form Health Survey (SF-36), with physical and mental component scores of quality of life, and the Hospital Anxiety and Depression Scale (HADS). Among subjects with psoriasis, the Psoriasis Area and Severity Index (PASI) and the Dermatology Life Quality Index (DLQI) were used, respectively, to measure the severity of psoriasis and the impact of psoriasis on the specific quality of life.
Compared to controls, patients with psoriasis showed higher HADS depression score and alcohol consumption, and lower QoL. Among subjects with psoriasis, multivariate analysis showed: 1) poorer physical QoL was associated with older age, articular lesions and anxious symptoms, whereas poorer mental QoL was associated with younger age, female sex, genital lesions and depressive symptoms; 2) the higher the severity of psoriasis, the lower the level of QoL and the higher the levels of anxious or depressive symptoms; and 3) female sex and articular or genital location of lesions are linked with higher HADS scores.
Higher scores in anxiety and depression and lower QoL is common in psoriasis, especially among women and those with genital or articular lesions. Dermatologists should give special attention to this subgroup of persons with psoriasis in order to prevent future psychopathology.
比较银屑病患者与对照组之间的生活质量（QoL）、焦虑和抑郁症状、饮酒等相关因素，并确定与 QoL 水平较低相关的银屑病特征。
纳入了 70 例中重度银屑病患者和 140 例无银屑病对照者的病例对照研究。所有参与者均回答了简明健康调查量表（SF-36），包括生活质量的生理和心理成分评分，以及医院焦虑抑郁量表（HADS）。在银屑病患者中，分别使用银屑病面积和严重程度指数（PASI）和皮肤病生活质量指数（DLQI）来衡量银屑病的严重程度和对特定生活质量的影响。
与对照组相比，银屑病患者的 HADS 抑郁评分和饮酒量较高，QoL 较低。在银屑病患者中，多变量分析显示：1）年龄较大、关节病变和焦虑症状与较差的生理 QoL 相关，而年龄较小、女性、生殖器病变和抑郁症状与较差的心理 QoL 相关；2）银屑病的严重程度越高，QoL 水平越低，焦虑或抑郁症状水平越高；3）女性和关节或生殖器病变部位与较高的 HADS 评分相关。
银屑病患者中焦虑和抑郁评分较高且 QoL 较低较为常见，尤其是女性和存在生殖器或关节病变的患者。皮肤科医生应特别关注这一亚组银屑病患者，以预防未来的精神病理学。
