Why Mental Health Screening Is Essential for Patients with Psoriatic Disease

Disability, pain and fatigue were patient-reported factors that raised the likelihood of depression and anxiety in both patient cohorts. The researchers noted a high rate of depression and anxiety in patients with PsA may go under-recognized and undertreated.²

Some researchers theorize that inflammation in the brain, as well as inflammatory diseases that affect the brain, could be a cause of depression, says Dr. Ogdie. It is a somewhat popular premise, but establishing a clear causal link is difficult, and more research is needed, she says.

Comorbidities

Although ways to manage psoriasis and PsA exist, so far neither condition has a cure, which is a bitter pill for some newly diagnosed patients. For any patient, the long-term nature and stresses of a chronic disease can be an emotional hurdle on the path to good mental health.

“People may begin to think they are going to live with this disease for the rest of their lives, and it can be overwhelming and depressing,” says Dr. Ogdie. “Of course, that’s the part we try to reframe, but that’s a pretty natural feeling.”

Even though it’s quite common for people with psoriatic disease to have depression, patients often don’t realize the two can be related, says Dr. Ogdie. She explains to them that their PsA is less likely to get better if their active mental illness isn’t addressed.

“You would really want to get the depression treated so they can start to feel better overall and have a better quality of life,” says Dr. Ogdie.

Both depression and anxiety are well recognized comorbidities in patients with psoriasis and PsA. Further, struggles with mental illness are fairly common in patients with any chronic rheumatic disease, notes Elaine Husni, MD, MPH, vice chair, Department of Rheumatologic and Immunologic Diseases, Cleveland Clinic.

Numerous studies have examined probable connections between poor mental health and psoriatic disease. But it can be tricky to ascertain whether depression and anxiety is more prevalent in one rheumatic illness compared to others because disease severity varies among conditions and patients, according to Dr. Husni.

“When considering the incidence of mental health issues among [patients with various] rheumatic diseases, it is essential to conduct comparative studies between similar disease states of lupus or psoriatic arthritis or rheumatoid arthritis before drawing any conclusions,” notes Dr. Husni.

Dr. Husni

“Only through such rigorous comparisons can we gain a comprehensive understanding of the potential differences in mental health impact between these conditions,” advises Dr. Husni, highlighting the importance of avoiding assumptions without proper comparative analysis.