Depression and anxiety in psoriatic disease: prevalence and associated factors
Open accessAbstract
OBJECTIVE: (1) To determine the prevalence of depression and anxiety in patients with psoriatic arthritis (PsA) and to identify associated demographic and disease-related factors. (2) To determine whether there is a difference in the prevalence of depression and anxiety between patients with PsA and those with psoriasis without PsA (PsC). METHODS: Consecutive patients attending PsA and dermatology clinics were assessed for depression and anxiety using the Hospital Anxiety and Depression Scale. Patients underwent a clinical assessment according to a standard protocol and completed questionnaires assessing their health and quality of life. T tests, ANOVA, and univariate and multivariate models were used to compare depression and anxiety prevalence between patient cohorts and to determine factors associated with depression and anxiety. RESULTS: We assessed 306 patients with PsA and 135 with PsC. There were significantly more men in the PsA group (61.4% vs 48% with PsC) and they were more likely to be unemployed. The prevalence of both anxiety and depression was higher in patients with PsA (36.6% and 22.2%, respectively) compared to those with PsC (24.4% and 9.6%; p = 0.012, 0.002). Depression and/or anxiety were associated with unemployment, female sex, and higher actively inflamed joint count as well as disability, pain, and fatigue. In the multivariate reduced model, employment was protective for depression (OR 0.36) and a 1-unit increase on the fatigue severity scale was associated with an increased risk of depression (OR 1.5). CONCLUSION: The rate of depression and anxiety is significantly higher in patients with PsA than in those with PsC. Depression and anxiety are associated with disease-related factors.
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The finding of anxiety in 17% of patients is higher than a global longitudinal study showing anxiety in 11% of psoriasis patients but in accordance with a Canadian study using the HADS.
“Our finding of anxiety in 17% of patients is higher compared with the findings of a global longitudinal study on psoriasis showing anxiety in 11% of patients (Kimball et al., 2014) but in accordance with a recent study of psoriasis patients from Canada using the HADS (McDonough et al., 2014).”
From The Psychological Burden of Skin Diseases: A Cross-Sectional Multicenter Study among Dermatological Out-Patients in 13 European Countries (2015) · cites this paper as McDonough et al., 2014
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Multimorbidity and comorbidity in psoriatic arthritis – a perspective
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Pharmacologic Treatment Strategies in Psoriatic Arthritis
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Does Age Matter in Psoriatic Arthritis? A Narrative Review
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Psychological and Sexual Consequences of Psoriasis Vulgaris on Patients and Their Partners
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State-of-the-Art Review of Pregnancy-Related Psoriasis
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How does the joint dermatology–rheumatology clinic benefit both patients and dermatologists?
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- Authors
- McDonough, E., Ayearst, R., Eder, L., Chandran, V., Rosen, C. F., Thavaneswaran, A., & Gladman, D. D.
- Affiliations
- University Health Network (CA)
- Corresponding author
- Gladman, Dafna D.
- Venue
- The Journal of Rheumatology
- Publisher
- The Journal of Rheumatology
- Published
- 2014-04-01
- Volume
- 41
- Issue
- 5
- Pages
- 887-896
- ISSN
- 0315-162X (ISSN-L)
- 1499-2752
- OpenAlex
- W2133432325
- Cited by
- 250
- References
- 50
- Citations by year
- 2026: 18 · 2025: 12 · 2024: 16 · 2023: 20 · 2022: 21 · 2021: 32 · 2020: 30 · 2019: 22 · 2018: 25 · 2017: 25 · 2016: 15 · 2015: 9 · 2014: 5
- FWCI
- 14.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Rheumatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Rheumatology Association
- Krembil Foundation
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Rheumatology › Spondyloarthritis Studies and Treatments
- Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- depression, anxiety, psoriatic arthritis, psoriasis, prevalence, unemployment, fatigue, disease activity, disability, sex differences, quality of life
- MeSH terms
- Activities of Daily Living, Adult, Aged, Anxiety Disorders, Depressive Disorder, Disability Evaluation, Female, Humans, Male, Middle Aged, Psoriasis, Quality of Life, Surveys and Questionnaires, Risk Factors, Arthritis, Psoriatic, Prevalence, Outcome Assessment, Health Care
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