Psychiatric Comorbidities in Patients with Psoriasis: A 10-Year Retrospective Epidemiological Study from a Tertiary...

Background and Objectives: Psoriasis (PsO) is a chronic autoimmune inflammatory skin disorder frequently associated with psychiatric and psychological burden. The objective of this study was to determine the incidence of psychiatric comorbidities in patients with PsO from a dermatology clinic of a university hospital in northeastern Romania, thereby providing physicians with evidence to support more holistic and integrated care approaches. Materials and Methods: This is a 10-year retrospective epidemiological study on 2219 patients diagnosed with PsOwho were admitted to a Romanian university hospital between January 2013 and December 2022. Psychiatric and dermatological diagnoses were extracted from medical records using International Classification of Diseases-Tenth Revision (ICD-10) codes. Relative risks (RR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards models, with p < 0.05 considered statistically significant. Results: Among 2219 patients, the most common psychiatric comorbidities were unspecified depressive disorder (120 patients, 5.4%, p < 0.01), mixed anxiety-depressive disorder (34 patients, 1.5%, p < 0.01), and mild depression (24 patients, 1.1%, p < 0.01). Female PsO patients demonstrated a relative risk (RR) [95% confidence interval (CI)] of 1.55 [1.12-2.14] (p = 0.007) for developing psychiatric comorbidities compared to males. Patients aged less than 18 years exhibited an RR [95% CI] of 2.032 [1.297-3.186] (p = 0.002) for psycho-emotional stress, the highest among all age groups. Notably, patients with concurrent psoriatic arthritis (PsA) showed a significantly elevated risk with RR [95% CI] of 1.546 [1.06-2.20] (p = 0.002). Conclusions: Depression and anxiety represent substantial psychiatric comorbidities in PsO patients, particularly affecting female individuals, younger patients, and those with concurrent PsA. These findings underscore the necessity for integrated mental health screening and psychological support within dermatological care protocols.