Pavlova N T, Kioskli K, Smith C, Picariello F, Rayner L, Moss-Morris R
Health Psychology Section, Psychology Department King's College London Institute of Psychiatry Psychology and Neuroscience London UK.
Department of Computer Science, Centre for Adaptive Computing Systems University of London London UK.
Skin Health Dis. 2021 May 3;1(2):e33. doi: 10.1002/ski2.33. eCollection 2021 Jun.
Excess weight is a common (30%-40%) multifactorial concern that remains understudied in adults with psoriasis.
This systematic review aimed to synthesise the evidence on the psychosocial factors associated with body weight in psoriasis and to use these findings to inform clinical practice. The review was registered with PROSPERO (registration number: CRD42020201138).
Electronic databases, related reviews and associated reference lists were searched. Observational and experimental studies reporting on the relationship of psychosocial factors to weight-related outcomes in adults with body mass index (BMI) of ≥30 kg/m and psoriasis were eligible. The methodological quality of the included studies was assessed using the Critical Appraisal Skills Programme (CASP).
Eighteen studies were included in the review, the majority of which ( = 16) examined cross-sectional associations between psychosocial factors and weight outcomes. Although the strengths of the associations were heterogeneous, most studies confirmed the positive association between high BMI and increased reports of depression and anxiety, impaired quality of life, deteriorated sleep quality, sexual dysfunction, and daily functioning issues. Only four studies were rated as high quality.
The current evidence of the association between psychosocial factors and weight-related outcomes is largely cross-sectional with unclear directionality of causality. Longitudinal studies are needed to examine the replicability and generalisability of the examined obesity-related psychosocial factors in psoriasis. Theoretical exploration of subgroup differences and similarities may pave the way towards intervention personalisation, and ultimately, improved patient outcomes.
超重是一个常见的（30%-40%）多因素问题，在成年银屑病患者中仍未得到充分研究。
本系统评价旨在综合关于银屑病患者体重相关心理社会因素的证据，并利用这些发现为临床实践提供参考。该评价已在PROSPERO注册（注册号：CRD42020201138）。
检索电子数据库、相关综述及相关参考文献列表。纳入体重指数（BMI）≥30 kg/m²的成年银屑病患者中，报告心理社会因素与体重相关结局关系的观察性和实验性研究。采用批判性评估技能计划（CASP）评估纳入研究的方法学质量。
本评价纳入18项研究，其中大多数（n = 16）研究了心理社会因素与体重结局之间的横断面关联。尽管关联强度存在异质性，但大多数研究证实高BMI与抑郁和焦虑报告增加、生活质量受损、睡眠质量恶化、性功能障碍及日常功能问题之间存在正相关。只有4项研究被评为高质量。
目前关于心理社会因素与体重相关结局之间关联的证据大多为横断面研究，因果关系的方向性尚不清楚。需要进行纵向研究，以检验银屑病中所研究的肥胖相关心理社会因素的可重复性和普遍性。对亚组差异和相似性的理论探索可能为干预个性化铺平道路，并最终改善患者结局。
