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Associations between psoriatic arthritis and mental health among patients with psoriasis: A replication and extension study using the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR)

BACKGROUND: Despite some evidence that psoriatic arthritis (PsA) may increase psychological burden in psoriasis, the mental health of this subpopulation is under‐investigated. OBJECTIVES: To investigate whether PsA is associated with higher depression and anxiety in moderate‐to‐severe psoriasis; exp...

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Autores principales: Lada, Georgia, Chinoy, Hector, Talbot, Peter S., Warren, Richard B., Kleyn, C. Elise
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9720192/
https://www.ncbi.nlm.nih.gov/pubmed/36479266
http://dx.doi.org/10.1002/ski2.149
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author Lada, Georgia
Chinoy, Hector
Talbot, Peter S.
Warren, Richard B.
Kleyn, C. Elise
author_facet Lada, Georgia
Chinoy, Hector
Talbot, Peter S.
Warren, Richard B.
Kleyn, C. Elise
author_sort Lada, Georgia
collection PubMed
description BACKGROUND: Despite some evidence that psoriatic arthritis (PsA) may increase psychological burden in psoriasis, the mental health of this subpopulation is under‐investigated. OBJECTIVES: To investigate whether PsA is associated with higher depression and anxiety in moderate‐to‐severe psoriasis; explore whether pain mediates these associations; and estimate the prevalence of undiagnosed and untreated depression. METHODS: Baseline data from British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR) participants completing the Hospital Anxiety and Depression Scale (HADS) were analysed. RESULTS: 707 patients (n = 540 with psoriasis only; n = 167 with PsA) were included. Depression prevalence was higher in patients with than without PsA, when a HADS‐depression subscale cut‐off ≥8 was used (33% vs. 23%, adjusted Odds Ratio [OR] (95% Confidence Intervals [CI]) = 1.64 (1.09–2.45)), but did not differ using the HADS cut‐off ≥ 11. Anxiety prevalence was higher among PsA patients, regardless of HADS cut‐off (cut‐off ≥11: adjusted OR (95% CI) = 1.62 (1.07–2.45)). Pain fully mediated the effect of PsA on depression and anxiety in psoriasis. 53.6% of participants identified as depressed did not have a known psychiatric disorder; two thirds of depressed participants were not treated. CONCLUSIONS: PsA comorbidity in psoriasis is associated with higher anxiety; its association with depression appears to be robust when milder depressive syndromes are included, but less consistent for higher‐threshold depression definitions. Depression remains unrecognized and untreated in over half of moderately‐to‐severe psoriasis patients. Routine depression and anxiety screening is recommended in psoriasis and PsA. PsA comorbidity may increase depression and anxiety in psoriasis through pain experience.
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spelling pubmed-97201922022-12-06 Associations between psoriatic arthritis and mental health among patients with psoriasis: A replication and extension study using the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) Lada, Georgia Chinoy, Hector Talbot, Peter S. Warren, Richard B. Kleyn, C. Elise Skin Health Dis Original Articles BACKGROUND: Despite some evidence that psoriatic arthritis (PsA) may increase psychological burden in psoriasis, the mental health of this subpopulation is under‐investigated. OBJECTIVES: To investigate whether PsA is associated with higher depression and anxiety in moderate‐to‐severe psoriasis; explore whether pain mediates these associations; and estimate the prevalence of undiagnosed and untreated depression. METHODS: Baseline data from British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR) participants completing the Hospital Anxiety and Depression Scale (HADS) were analysed. RESULTS: 707 patients (n = 540 with psoriasis only; n = 167 with PsA) were included. Depression prevalence was higher in patients with than without PsA, when a HADS‐depression subscale cut‐off ≥8 was used (33% vs. 23%, adjusted Odds Ratio [OR] (95% Confidence Intervals [CI]) = 1.64 (1.09–2.45)), but did not differ using the HADS cut‐off ≥ 11. Anxiety prevalence was higher among PsA patients, regardless of HADS cut‐off (cut‐off ≥11: adjusted OR (95% CI) = 1.62 (1.07–2.45)). Pain fully mediated the effect of PsA on depression and anxiety in psoriasis. 53.6% of participants identified as depressed did not have a known psychiatric disorder; two thirds of depressed participants were not treated. CONCLUSIONS: PsA comorbidity in psoriasis is associated with higher anxiety; its association with depression appears to be robust when milder depressive syndromes are included, but less consistent for higher‐threshold depression definitions. Depression remains unrecognized and untreated in over half of moderately‐to‐severe psoriasis patients. Routine depression and anxiety screening is recommended in psoriasis and PsA. PsA comorbidity may increase depression and anxiety in psoriasis through pain experience. John Wiley and Sons Inc. 2022-07-06 /pmc/articles/PMC9720192/ /pubmed/36479266 http://dx.doi.org/10.1002/ski2.149 Text en © 2022 The Authors. Skin Health and Disease published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Lada, Georgia
Chinoy, Hector
Talbot, Peter S.
Warren, Richard B.
Kleyn, C. Elise
Associations between psoriatic arthritis and mental health among patients with psoriasis: A replication and extension study using the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR)
title Associations between psoriatic arthritis and mental health among patients with psoriasis: A replication and extension study using the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR)
title_full Associations between psoriatic arthritis and mental health among patients with psoriasis: A replication and extension study using the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR)
title_fullStr Associations between psoriatic arthritis and mental health among patients with psoriasis: A replication and extension study using the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR)
title_full_unstemmed Associations between psoriatic arthritis and mental health among patients with psoriasis: A replication and extension study using the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR)
title_short Associations between psoriatic arthritis and mental health among patients with psoriasis: A replication and extension study using the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR)
title_sort associations between psoriatic arthritis and mental health among patients with psoriasis: a replication and extension study using the british association of dermatologists biologics and immunomodulators register (badbir)
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9720192/
https://www.ncbi.nlm.nih.gov/pubmed/36479266
http://dx.doi.org/10.1002/ski2.149
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