Psychological and socioeconomic factors associated with depression and anxiety among patients with psoriasis

Abstract

Patients with psoriasis have an increased prevalence of depression and anxiety compared to the general population. Previous studies linked sex, age and psoriasis severity to depression and/or anxiety (DA), but research on factors like psoriasis visibility, stress, socioeconomic status and social support is limited. This study explored factors associated with moderate-to-severe DA in patients with psoriasis, assessing both well-known patient characteristics (sex, age and disease severity) and psychological and socioeconomic factors. A web-based survey among psoriasis patients was conducted. The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) were used to assess symptoms of depression and anxiety respectively. Multivariable logistic regression analyses were used to assess associations between moderate-to-severe DA and possible contributing factors. Of 267 patients, 54 (20.2%) screened positive for symptoms of depression (PHQ-9 ≥ 10) and/or symptoms of anxiety (GAD-7 ≥ 10). Stress (OR 23.34, 95%CI = 3.01-181.21), low income (OR 2.90, 95%CI = 1.14–7.35), and low education level (OR 2.32, 95%CI = 1.04–5.15) were associated with DA, while sex (OR 1.40, 95%CI = 0.60–3.26), age (OR 0.82, 95%CI = 0.65–1.05) and psoriasis severity (OR 1.98, 95%CI = 0.97–4.03) were not significantly associated. Sensitivity analysis showed association of low perceived social support (OR 11.30, 95%CI = 4.02–31.79), psoriasis severity (OR 2.25, 95%CI = 1.01–4.97), and age (OR 0.71, 95%CI = 0.54–0.93) with DA. Stress and low perceived social support were strongly associated with moderate-to-severe DA in patients with psoriasis. Less strong associations were found for low income, low education level, psoriasis severity, and age. This emphasizes the need for additional support beyond the medical domain to address the mental health of patients with psoriasis.