Luna Paula C, Chu Chia-Yu, Fatani Mohammad, Borlenghi Cecilia, Adora Anna, Llamado Lyndon Q, Wee James
Hospital Aleman, Arenales 2557 1a ZC 1425, Buenos Aires, Argentina.
Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan.
Dermatol Ther (Heidelb). 2023 Dec;13(12):3043-3055. doi: 10.1007/s13555-023-01060-5. Epub 2023 Nov 23.
Psoriasis is associated with various comorbidities with a notable psychosocial burden. This systematic literature review explores the burden of depression in patients with psoriasis, comparing it with that experienced by patients with other chronic medical conditions. Embase via Ovid, PubMed, and Cochrane Database of Systematic Reviews via Ovid were searched for peer-reviewed studies published in English between January 1, 2016 and December 6, 2021 that reported real-world evidence or observational studies involving at least 100 adults (age ≥ 18 years) with general (unspecified) or plaque psoriasis experiencing symptoms of depression (but not restricted to patients with a clinical diagnosis). Any report of depression or suicidality was eligible for inclusion. Systematic literature reviews reporting depression/suicidality in other chronic medical conditions were also included. Statistical analysis was not performed; the study was descriptive only. A total of 1744 records were identified, and after several defined screenings by two independent reviewers for publication year, relevance, and sample size, 82 publications were included. Psoriasis was significantly associated with depression. The prevalence of depression in patients with psoriasis ranged from 0.2% to 74.6%, with incidence from 4.83 to 91.9 per 1000 person-years. The prevalence of depression was generally higher among patients with more severe psoriasis than those with less severe disease (as determined by Psoriasis Area Severity Index [PASI] scoring system) and was more prevalent among women than men with psoriasis. Depression in psoriasis significantly reduced quality of life, including factors such as sexual dysfunction, sleep difficulties, subjective well-being, and addictions. Comorbid hypertension, hyperlipidemia, psoriatic arthritis, obesity, inflammatory bowel disease, diabetes, and statin use were all associated with increased depression risk in patients with psoriasis. This systematic literature review found that the burden of depression in psoriasis is no lower than in other chronic medical conditions. Greater awareness of the psychological impact of psoriasis would improve care and management, which should incorporate psychological interventions.
银屑病与多种合并症相关，具有显著的社会心理负担。本系统文献综述探讨了银屑病患者的抑郁负担，并将其与其他慢性疾病患者的抑郁负担进行比较。通过Ovid检索Embase、PubMed以及通过Ovid检索Cochrane系统评价数据库，查找2016年1月1日至2021年12月6日期间发表的英文同行评审研究，这些研究报告了涉及至少100名患有全身性（未指定）或斑块状银屑病且有抑郁症状（但不限于临床诊断患者）的成年人（年龄≥18岁）的真实世界证据或观察性研究。任何关于抑郁或自杀倾向的报告均符合纳入标准。还纳入了报告其他慢性疾病中抑郁/自杀倾向的系统文献综述。未进行统计分析；该研究仅为描述性研究。共识别出1744条记录，经过两位独立评审员根据发表年份、相关性和样本量进行的多次明确筛选后，纳入了82篇出版物。银屑病与抑郁显著相关。银屑病患者的抑郁患病率在0.2%至74.6%之间，发病率为每1000人年4.83至91.9例。银屑病更严重的患者（根据银屑病面积和严重程度指数[PASI]评分系统确定）的抑郁患病率通常高于病情较轻的患者，且女性银屑病患者的抑郁患病率高于男性。银屑病中的抑郁显著降低了生活质量，包括性功能障碍、睡眠困难、主观幸福感和成瘾等因素。合并高血压、高脂血症、银屑病关节炎、肥胖、炎症性肠病、糖尿病以及使用他汀类药物均与银屑病患者的抑郁风险增加相关。本系统文献综述发现，银屑病的抑郁负担不低于其他慢性疾病。提高对银屑病心理影响的认识将改善护理和管理，其中应纳入心理干预措施。
