Risk of Depression in Patients With Psoriatic Disease: A Systematic Review and Meta-Analysis

Area of Science:

• Dermatology and Psychiatry
• Epidemiology of Chronic Diseases
• Mental Health Research

Background:

• Previous reviews focused on prevalence and odds ratios for depression in psoriatic disease, which are difficult to interpret due to bidirectional effects.
• No prior systematic reviews have quantified the relative risk (RR) of depression following a psoriatic disease diagnosis.
• Psoriatic disease encompasses conditions like psoriasis and psoriatic arthritis, impacting a significant patient population.

Purpose of the Study:

• To estimate the relative risk (RR) of depression in individuals diagnosed with psoriasis.
• To specifically assess the RR of depression in subgroups: psoriatic arthritis (PsA), clear-to-moderate psoriasis, and moderate-to-severe psoriasis.

Main Methods:

• Systematic search of Medline, EMBASE, PsycINFO, and CINAHL for observational studies on depression risk in psoriatic disease.
• Inclusion of 31 studies, with 17 undergoing meta-analysis using random effects models.
• Exploration of heterogeneity sources via subgroup analysis and meta-regression.

Main Results:

• The pooled relative risk (RR) of depression in psoriasis patients versus non-psoriatic controls was 1.48 (95% CI: 1.16-1.89).
• High heterogeneity (I² = 99.8%) was observed across studies.
• Subgroup analyses and meta-regression did not identify PsA status or psoriasis severity as significant sources of heterogeneity; no publication bias was detected.

Conclusions:

• Patients with psoriasis and psoriatic arthritis exhibit an elevated risk of depression.
• This finding underscores the critical need for enhanced mental health support strategies for this population.
• Future research should prioritize primary prevention, early detection, and effective treatment interventions for depression in individuals with psoriatic diseases.