Common Fundamentals of Psoriasis and Depression

Abstract

Psoriasis is an inflammatory, immune-mediated disease that is frequently associated with psychological comorbidities such as depression. The stigma patients feel because of the appearance of their skin may contribute to the high psycho-social burden of psoriasis. However, there is emerging evidence that overlapping biological mechanisms are, to a substantial degree, responsible for the close interaction between psoriasis and depression. Increased proinflammatory mediators, such as C-reactive protein or interleukin-6, are present in both psoriasis and depression, indicating that inflammation may represent a pathophysiological link between the diseases. Anti-inflammatory biologic therapies treat the clinical manifestations of psoriasis, but might also play a significant role in reducing associated depressive symptoms in patients with psoriasis. Comparison between single studies focusing on the change in depressive symptoms in psoriasis is limited by inconsistency in the depression screening tools applied.

Fig. 1

Psoriasis is a chronic inflammatory disease, frequently associated with depressive symptoms, which, on the one hand, are in part induced by the appearance of the skin and the resulting stigmatization felt by patients. However, on the other hand, there is emerging evidence that increased peripheral inflammatory responses are responsible for the induction and maintenance of depressive symptoms. In addition, psycho-social stress also affects immune responses. Future research is needed to unravel these functional interconnections among inflammatory responses, psoriasis and depressive symptoms. The insights obtained need to be considered in clinical practice.