An Association Analysis of Anxiety and Psoriasis: Based on the NHANES Database

Psoriasis is linked with an elevated risk of anxiety disorders, and there may be a temporal relationship between the two. However, the association between anxiety status and its duration with psoriasis is unclear.

The present work aimed to figure out the association between anxiety and the risk of psoriasis.

Data from the National Health and Nutrition Examination Survey (NHANES) 2009-2012 were used. Anxiety state and days of anxiety were applied as the independent variables, and psoriasis as the dependent variable. Weighted logistic regression was employed to analyze the connection between the state and days of anxiety with psoriasis. Restricted cubic spline (RCS) was further utilized to dig out the nonlinear association between days of anxiety and psoriasis. By using weighted logistic regression to further explore the correlation between the combination of anxiety and common cardiovascular risk factors (smoking, hypertension, CVD events) and the risk of psoriasis. Finally, a weighted logistic regression model was constructed for different genders and alcohol consumption subgroups to explore the association between anxiety status and anxiety days and psoriasis and to evaluate the differences in association among different groups.

A total of 8888 participants were included in this project, among whom 265 cases (3.1%) were psoriasis patients. Through the weighted logistics regression model, we observed a significant positive correlation between anxiety (OR: 1.439, 95% CI: 1.008-2.053, p = 0.030), number of days with anxiety (OR: 1.018, 95% CI: 1.002-1.033, p = 0.014), and the risk of psoriasis in patients. The RCS curve results indicated a linear positive correlation between anxiety days and the risk of psoriasis (p-nonlinear = 0.162). The results of the joint analysis demonstrated that anxiety^-/smoking⁺ (OR: 1.800, 95% CI: 1.160-2.800, p = 0.011), anxiety⁺/smoking⁺ (OR: 2.720, 95% CI: 1.430-5.190, p = 0.004), anxiety⁺/hypertension⁺ (OR: 2.010, 95% CI: 1.200-3.370, p = 0.011), anxiety^-/CVD event⁺ (OR: 1.740, 95% CI: 1.080-2.820, p = 0.026), and anxiety⁺/CVD event^- (OR:1.470, 95% CI: 1.000-2.150, p = 0.047) were linked with a significantly elevated risk of psoriasis. The subgroup analysis results showed that women (especially those who drink alcohol) were more sensitive to anxiety status and duration, and the association between increased anxiety days and increased risk of psoriasis was more significant, while no similar significant association was observed in men.

Anxiety and the number of days with anxiety are positively linked with the risk of psoriasis. Individuals with anxiety⁺/smoking⁺ or anxiety⁺/hypertension⁺ have a higher risk of developing psoriasis. We recommended that, in the prevention and management of psoriasis, individuals need to cope with stress to alleviate anxiety symptoms and try not to smoke. Women should pay special attention to regulating anxiety while drinking alcohol and monitoring blood pressure and cardiovascular health regularly.