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Larger impact seen from somatic comorbidity on psoriasis patients' mental health

New research conducted at Umeå University in Sweden shows somatic diseases such as depression, anxiety and suicide have a more significant impact on the mental health of psoriasis patients than their skin symptoms, highlighting the importance of complete patient care.

The study, which looked at the mental health of psoriasis patients, was published online ahead of print in JAMA Dermatology (June 3, 2020). The study was led by Kirk Geale, a PhD candidate at Umeå University.

Many psoriasis patients have other physical conditions such as being overweight, diabetes, and heart diseases.

“What we did not know before is how psoriasis skin symptoms and other somatic diseases associated with psoriasis impact mental health,” said Dr. Marcus Schmitt-Egenolf, a dermatologist and professor at Umeå University, in a press release.

The study’s authors note that previous research has concluded that psoriasis patients more often deal with somatic and mental diseases compared to those without psoriasis. The Umeå University research confirmed prior findings and also investigated how psoriasis skin symptoms and associated somatic diseases impacted mental health, considering anxiety, depression and suicide together.

Researchers found skin symptoms have an important impact on mental health, but that other somatic diseases associated with psoriasis can cause even more harm to the patient’s mental health.

“We found that skin symptoms increased the risk of mental illness by a third, while other physical illnesses doubled the risk among psoriasis patients,” said Geale.

The study was conducted between 2017 and 2019 using nationwide data from aproximately 100,000 individuals in Sweden with psoriasis, but without earlier mental diseases. They were compared to a control group without psoriasis.

Results of the study showed a 32% increase in the risk of mental illness caused by skin symptoms and a 109% increase in the risk from other somatic illnesses.

Researchers believe the information gathered is important since the total burden of mental health on psoriasis patients, and what contributes to it, was not well established previously.

The study’s findings encourage psoriasis patients to speak with their doctors about symptoms beyond the skin, both physical and mental. It also encourages doctors to proactively discuss these issues with their patients.

“I would be delighted if our study could support the trend towards a more holistic view on psoriasis care. At the doctor’s office, lifestyle factors should be discussed in the awareness that individual responsibility may be limited by available personal and community resources. Such an approach may improve the complete triad of psoriasis—skin symptoms, somatic, and mental health alike,” concluded Dr. Schmitt-Egenolf.

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