The Bidirectional Relationship between Psoriatic Arthritis and Mental Health: A Comprehensive Review

Psoriatic arthritis (PsA) is a long-standing inflammatory immune-mediated condition that involves articular and peri-articular tissues and frequently accompanies psoriasis (PsO). It is defined by chronic joint inflammation, pain, and structural damage, resulting in impairment of physical function and quality of life. Increasing evidence points to the close relationship between PsA and mental disorders, especially depression and anxiety.

This review utilized an extensive literature search approach to select studies addressing the correlation between psoriatic arthritis (PsA) and mental comorbidities such as depression, anxiety, and their influence on quality of life and the disease course. Databases like PubMed, Scopus, Web of Science, and Google Scholar were utilized up to 2024 with applicable keywords and Boolean operators.

The mutual interaction between PsA and psychological distress is moderated by mechanisms including chronic pain, systemic inflammation, physical disability, and the social stigma of psoriatic lesions. Research suggests that patients with PsA exhibit an increased frequency of anxiety and depression in comparison to the general population, and that mental illness augments the severity of the disease and affects the outcome of treatments adversely. In addition, PsA may also cause systemic inflammation that might lead to neurocognitive dysfunction, adding to the risk for mood disorders.

Although there is a long-standing, well-documented psychosocial morbidity associated with PsA, mental health comorbidities are frequently underdiagnosed and undertreated. Psychological distress must be treated as an integral part of PsA management to enhance patient-reported outcomes as well as quality of life.

This review examines the complex interaction between PsA and mental health, considers the possible underlying mechanisms, and highlights the necessity of an integrated, multidisciplinary treatment strategy for patients.