The Effects of Methotrexate and Biologics on the Symptoms of Depression and Anxiety in Patients with Psoriasis

BACKGROUND: In patients with psoriasis, psychiatric co-morbidities accompany quite frequently. AIMS AND OBJECTIVES: We aimed to compare the effects of methotrexate and biologics on psychiatric comorbidities, and also examine the relationship of these symptoms with systemic inflammation parameters. MATERIALS AND METHODS: Sixty patients with psoriasis treated with biologics or methotrexate were enrolled. At the baseline and the 24(th) week of the treatment, the patients filled Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Dermatology Life Quality Index (DLQI), inflammation was assessed with serum C-reactive protein (CRP) and tumour necrosis factor-alpha (TNF-α) levels. RESULTS: The decrease in BAI and BDI scores at the 24(th) week was significant in both the groups. When the decrease in BAI and BDI scores of the two groups were compared, no significant differences were found between the groups. The decrease in DLQI scores of the patients who received biologics was significantly superior compared to the patients who received methotrexate (P = 0.007). There was no significant correlation between the change in serum inflammation parameters and the decrease in the BDI/BAI scores. CONCLUSIONS: In patients with psoriasis, biologics and methotrexate reduce the symptoms of depression and anxiety. The difference between the two groups was insignificant. Biologics improve the quality of life better than methotrexate. Systemic inflammation parameters do not reflect the changes in these symptoms in such patients.