Psoriasis is a common systemic inflammatory disease with multiple known comorbidities. We review the literature focusing on the psychological comorbidities that have been reported. We discuss the impact of psoriasis on stress and sleep disorders in addition to depression. Alcohol abuse and nicotine addiction are prevalent in this population, as are psychological problems in children and teenagers who develop psoriasis early in life. We summarize the proposed pathophysiology and known treatments for these comorbidities.
PrussickR.PrussickL.. Biologic Therapies for Psoriasis: Do we use them enough?Practical Dermatology.2013; (102): 32–4.
2.
RappS.R.FeldmanS.R.ExumM.L.Psoriasis causes as much disability as other major medical diseases.J Am Acad Dermatol1999 (3); 4–1: 401–7.
3.
KimballA.B.GladmanD.GelfandJ.M.National Psoriasis Foundation clinical consensus on psoriasis comorbidities and recommendations for screening.J Am Acad Dermatol.2008; 58(6): 1031–42.
4.
GinsburgI.H.LinkB.G.. Psychosocial consequences of rejection and stigma feelings in psoriasis patients.Int J Dermatol.1993; 32(8): 587–91.
5.
RichardsH.L.FortuneD.G.GriffithsC.E.The contribution of perceptions of stigmatization to disability in patients with psoriasis.J Psychosom Res.2001; 50(1): 11–15.
6.
MaginP.J.PondC.D.SmithW.T.A cross-sectional study of psychological morbidity in patients with acne, psoriasis and atopic dermatitis in specialist dermatology and general practices.J Eur Acad Dermatol Venereol2008; 22(12): 1435–44.
7.
SchmittJ.FordD.E.. Psoriasis is independently associated with psychiatric morbidity and adverse cardiovascular risk factors but not with cardiovascular events in a population-based sample.J Eur Acad Dermatol Venereol.2010; 24(8): 885–92.
8.
KentG.KeohaneS.. Social Anxiety and disfigurement: the moderating effects of fear of negative evaluation and past experience.Br J Clin Psychol.2001; 40(1): 23–34.
9.
O'LearyC.J.CreamerD.HigginsE.WeinmanJ.. Perceived stress stress attributions and psychological distress in psoriasis.J Psychosom Res.2004; 57(5): 465–71.
10.
LevensonJ.. Psychiatric Issues in Dermatology. Atopic dermatitis and psoriasis.Prim Psychiatry.2008; 15: 35–8.
11.
GuptaM.A.GuptaA.K.WatteelG.N.. Perceived deprivation of social touch in psoriasis is associated with greater psychological morbidity.Cutis.1998; 61(6): 339–42.
12.
ShuttyB.G.WestC.HuangK.E.Sleep disturbances in psoriasis.Dermatol Online J.2013; 19(1): 1.
13.
GuptaM.A.GuptaA.K.KirkbyS.Pruritus in psoriasis. A prospective study of some psychiatric and dermatologic correlates.Arch Dermatol.1988; 124(7): 1052–7.
14.
KurdS.K.TroxelA.B.Crits-ChristophP.GelfandJ.M.. The risk of depression, anxiety and suicidality in patients with psoriasis: a population-based cohort study.Arch Dermatol.2010; 146(8): 891–5.
15.
SchmittJ.FordD.E.. Understanding the relationship between objective disease severity, psoriatic symptoms, illness-related stress, health-related quality of life and depressive symptoms in patients with psoriasis.Gen Hosp Psychiatry.2007; 29(2): 134–40.
16.
KooJ.. Population-based epidemiologic study of psoriasis with emphasis on quality of life assessment.Dermatol Clin1996; 14(3): 485–96.
17.
GuptaM.A.GuptaA.K.. Depression modulates pruritus perception a study of pruritus in psoriasis, atopic dermatitis, and chronic idiopathic urticaria. Ann N.Y.Acad Sci.1999; 885: 394–5.
18.
GuptaM.A.SchorkN.J.GuptaA.K.Suicidal ideation in psoriasis.Int J Dermatol.1993; 32(3): 188–90.
19.
GuptaM.A.GuptaA.K.. Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis.Br J Dermatol.1998; 139(5): 846–50.
20.
KruegerG.KooJ.LebwohlM.The impact of psoriasis on quality of life: results of a 1998 National Psoriasis Foundation patient membership survey.Arch Dermatol.2001; 137(3): 280–4.
21.
PoikolainenK.ReunalaT.KarvonenJ.Alcohol intake: a risk factor for psoriasis in young and middle-aged men?BMJ1990; 300(6727): 780–3.
22.
QureshiA.A.DominquezP.L.ChoiH.K.Alcohol intake and risk of incident psoriasis in US women: a prospective study.Arch Dermatol.2010; 146(12): 1364–9.
23.
KirbyB.RichardsH.L.MasonD.L.Alcohol consumption and psychological distress in patients with psoriasis.Br J Dermatol.2008; 158(1): 138–40.
24.
BrenautE.HorreauC.PouplardC.Alcohol consumption and psoriasis: a systemic literature review.J Eur Acad Dermatol Venereol.2013; 27: 30–5.
25.
PoikolainenK.KarvonenJ.PukkalaE.. Excess mortality related to alcohol and smoking among hospital-treated patients with psoriasis.Arch Dermatol.1999; 135(12): 1490–3.
SongZ.ZhouZ.UriarteS.S-adenosylhomocysteine sensitizes to TNF-alpha hepatotoxicity in mice and liver cells: a possible etiological factor in alcoholic liver disease.Hepatology2004; 40(4): 989–97.
28.
SettyA.R.CurhanG.ChoiH.K.. Smoking and the risk of psoriasis in women- Nurses Health Study II.Am J Med.2007; 120(11): 953–9.
29.
NaldiL.PeliL.ParazziniF.. Association of early stage psoriasis with smoking and male alcohol consumption.Arch Dermatol.1999; 135(12): 1479–85.
30.
PoikolainenK.ReunalaT.KarvonenJ.. Smoking, alcohol and life events related to psoriasis among women.Br J Dermatol.1994130(4): 473–77.
31.
ZhangX.WangH.Te-ShaoH.Frequent use of tobacco and alcohol in Chinese psoriasis patients.Int J Dermatol.2002; 41(10): 659–662.
32.
RaychaudhuriS.P.GrossJ.. Psoriasis risk factors: role of lifestyle practices.Cutis.2000; 66(5): 348–52.
33.
NaldiL.. Cigarette smoking and psoriasis.Clin Dermatol1998; 16(5): 571–4.
34.
ArmstrongA.W.ArmstrongE.J.FullerE.N.Smoking and pathogenesis of psoriasis.Br J Dermatol.2011; 165(6): 1162–8.
NikamoP.CheukS.LysellJ.Genetic variants of the Il–22 promoter associate to onset of psoriasis before puberty and increased IL-22 production in T cells.J Invest Dermatol.2014; 134(6): 1535–41.
37.
PerrottS.B.MurrayA.H.LoweJ.The psychosocial impact of psoriasis: physical severity, quality of life, and stigmatizationPhysiol Behav.2000; 70(5): 567–71.
38.
RemrodC.SjostromK.SvenssonA.. Psychological differences between early and late-onset psoriasis: a study of personality traits, anxiety and depression in psoriasis.Br J Dermatol.2013; 169(2): 344–50.
DowlatiY.HerrmannN.SwardfagerW.A meta-analysis of cytokines in major depression.Biol Psychiatry.2010; 67(5): 446–57.
41.
TugluC.KaraS.H.CalivurtO.Increased serum tumor necrosis factor-alpha levels and treatment response in major depressive disorder.Psychopharmacology.2003; 170(4): 429–33.
42.
FortuneD.G.RichardsH.L.GriffithsC.E.Psychological stress distress, and disability in patients with psoriasis.Br J Clin Psychol.2002; 41(2): 157–74.
43.
FortuneD.G.RichardsH.L.KirbyB.Psychological stress impairs clearance of psoriasis in patients treated with photochemotherapy.Arch Dermatol.2003; 139(6): 752–6.
44.
ModellJ.G.BoyceS.TaylorE.Treatment of atopic dermatitis and psoriasis vulgaris with bupropion-SR: a pilot study.Psychosom Med.2002; 64(5): 835–40.
45.
TamerE.GurG.PolatM.Flare-up of pustular psoriasis with fluoxetine: possibility of a serotoninergic influence?J Dermatol Treat.2009; 20(3): 1–3.
46.
CoxN.H.GordonP.M.DoddH.. Generalized pustular and erythrodermic psoriasis associated with bupropion treatmentBr J Dermatol.2002; 146(6): 1061–63.
47.
TyringS.GottliebA.PappK.Etanercept and clinical outcomes, fatigue and depression in psoriasis: double-blind placebo controlled randomized phase III trial.Lancet2006; 367(9504): 29–35.
48.
FeldmanS.R.GottliebA.BalaM.Infliximab improves he alt h-related quality of life in the presence of comorbidities among patients with moderate-to-severe psoriasis.Br J Dermatol2008; 159(3): 704–10.
49.
MenterA.AugustinM.SignorovitchJ.The effect of adalimumab on reducing depression symptoms in patients with moderate to severe psoriasis: a randomized clinical trial.J Am Acad Dermatol.2010; 62(5): 812–8.
50.
RichardsH.L.FortuneD.G.WeidmannA.SweeneyS.K.GriffithsC.E.. Detection of psychological distress in patients with psoriasis: low consensus between dermatologist and patient.Br J Dermatol.2004; 151(6): 1227–33.
