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The bidirectional causal association between psoriasis and psychological illnesses: a 2-sample Mendelian randomization study

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Abstract

There have been reports of association between psoriasis and psychological illnesses. Nevertheless, it is not easy to draw conclusions with high quality causality from conventional observational studies. The objective of this study was to evaluate the causality of psoriasis and psychological illnesses. All summary-level data from genome-wide association studies for psoriasis and psychological illnesses were collected from Neale Lab and MRC Integrative Epidemiology Unit. Bidirectional Mendelian randomization analysis was performed to determine the random orientation with an independent genetic variation. The main estimated effects are derived using Inverse-Variance Weighted, weighted median, and MR Egger methods. Multiple data sets were validated against each other, and a series of sensitivity studies were conducted to ensure the reliability of the results. Mendelian randomization analysis revealed a causal effect of psoriasis [odds ratio (OR) 1·34, 95% confidence interval (CI) 1·21–1·46, P < 0.001; and OR 1.28, CI 1.17–1.39, P < 0.001] on psychological illnesses, and vice versa (OR 1.23, CI 1.14–1.31, P < 0.001; and OR 1.21, CI 1.11–1.31, P < 0.001). The results were supported by a series of sensitivity analyses. The findings of this Mendelian randomization study support a causal effect between psoriasis and psychological illnesses, and vice versa.

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Data availability

The data underlying this article were provided by IEU OpenGWAS by permission. All of the datasets are freely available from https://gwas.mrcieu.ac.uk/.

References

  1. Rendon A, Schäkel K (2019) Psoriasis pathogenesis and treatment. Int J Mol Sci 20(6):1475. https://doi.org/10.3390/ijms20061475

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker JNWN (2021) Psoriasis. The Lancet 397(10281):1301–1315. https://doi.org/10.1016/S0140-6736(20)32549-6

    Article  CAS  Google Scholar 

  3. Kamiya K, Kishimoto M, Sugai J, Komine M, Ohtsuki M (2019) Risk factors for the development of psoriasis. Int J Mol Sci 20(18):E4347. https://doi.org/10.3390/ijms20184347

    Article  CAS  Google Scholar 

  4. Takeshita J, Grewal S, Langan SM et al (2017) Psoriasis and comorbid diseases part II. implications for management. J Am Acad Dermatol 76(3):393–403. https://doi.org/10.1016/j.jaad.2016.07.065

    Article  PubMed  PubMed Central  Google Scholar 

  5. Armstrong AW, Read C (2020) Pathophysiology, clinical presentation, and treatment of psoriasis: a review. JAMA 323(19):1945–1960. https://doi.org/10.1001/jama.2020.4006

    Article  CAS  PubMed  Google Scholar 

  6. Tohid H, Aleem D, Jackson C (2016) Major depression and psoriasis: a psychodermatological phenomenon. SPP 29(4):220–230. https://doi.org/10.1159/000448122

    Article  CAS  Google Scholar 

  7. Bell KA, Balogh EA, Feldman SR (2021) An update on the impact of depression on the treatment of psoriasis. Expert Opin Pharmacother 22(6):695–703. https://doi.org/10.1080/14656566.2020.1849141

    Article  CAS  PubMed  Google Scholar 

  8. Amanat M, Salehi M, Rezaei N (2018) Neurological and psychiatric disorders in psoriasis. Rev Neurosci 29(7):805–813. https://doi.org/10.1515/revneuro-2017-0108

    Article  PubMed  Google Scholar 

  9. Pollo CF, Miot HA, de Matos TD et al (2021) Prevalence and factors associated with depression and anxiety in patients with psoriasis. J Clin Nurs 30(3–4):572–580. https://doi.org/10.1111/jocn.15577

    Article  PubMed  Google Scholar 

  10. Yu S, Tu HP, Huang YC, Lan CCE (2019) The incidence of anxiety may not be correlated with severity of psoriasis: a prospective pilot study. Med Hypotheses 130:109254. https://doi.org/10.1016/j.mehy.2019.109254

    Article  PubMed  Google Scholar 

  11. Matiushenko VP, Kutasevych YF, Havryliuk OA, Jafferany M (2020) Effectiveness of psychopharmacotherapy in psoriasis patients with associated anxiety and depression. Dermatol Ther 33(6):e14292. https://doi.org/10.1111/dth.14292

    Article  CAS  PubMed  Google Scholar 

  12. Levy I (2022) Stress, anxiety, and depression in times of COVID-19: Gender, individual quarantine, pandemic duration and employment. Front Public Health 10:999795. https://doi.org/10.3389/fpubh.2022.999795

    Article  PubMed  PubMed Central  Google Scholar 

  13. Burgess S, Small DS, Thompson SG (2017) A review of instrumental variable estimators for Mendelian randomization. Stat Methods Med Res 26(5):2333–2355. https://doi.org/10.1177/0962280215597579

    Article  PubMed  Google Scholar 

  14. Wei J, Zhu J, Xu H et al (2022) Alcohol consumption and smoking in relation to psoriasis: a Mendelian randomization study. Br J Dermatol. https://doi.org/10.1111/bjd.21718

    Article  PubMed  PubMed Central  Google Scholar 

  15. Freuer D, Linseisen J, Meisinger C (2022) Association between inflammatory bowel disease and both psoriasis and psoriatic arthritis: a bidirectional 2-sample Mendelian randomization study. JAMA Dermatol. https://doi.org/10.1001/jamadermatol.2022.3682

    Article  PubMed  PubMed Central  Google Scholar 

  16. Gu X, Chen X, Shen M (2022) Association of psoriasis with risk of COVID-19: A 2-sample Mendelian randomization study. J Am Acad Dermatol 87(3):715–717. https://doi.org/10.1016/j.jaad.2022.01.048

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Bowden J, Davey Smith G, Haycock PC, Burgess S (2016) Consistent estimation in Mendelian randomization with some invalid instruments using a weighted median estimator. Genet Epidemiol 40(4):304–314. https://doi.org/10.1002/gepi.21965

    Article  PubMed  PubMed Central  Google Scholar 

  18. Burgess S, Thompson SG (2017) Interpreting findings from Mendelian randomization using the MR-Egger method. Eur J Epidemiol 32(5):377–389. https://doi.org/10.1007/s10654-017-0255-x

    Article  PubMed  PubMed Central  Google Scholar 

  19. Kemp JP, Sayers A, Smith GD, Tobias JH, Evans DM (2016) Using Mendelian randomization to investigate a possible causal relationship between adiposity and increased bone mineral density at different skeletal sites in children. Int J Epidemiol 45(5):1560–1572. https://doi.org/10.1093/ije/dyw079

    Article  PubMed  PubMed Central  Google Scholar 

  20. Cohen BE, Martires KJ, Ho RS (2016) Psoriasis and the risk of depression in the US population: national health and nutrition examination survey 2009–2012. JAMA Dermatol 152(1):73–79. https://doi.org/10.1001/jamadermatol.2015.3605

    Article  PubMed  Google Scholar 

  21. Egeberg A, Thyssen JP, Wu JJ, Skov L (2019) Risk of first-time and recurrent depression in patients with psoriasis: a population-based cohort study. Br J Dermatol 180(1):116–121. https://doi.org/10.1111/bjd.17208

    Article  CAS  PubMed  Google Scholar 

  22. Dalgard FJ, Gieler U, Tomas-Aragones L et al (2015) The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol 135(4):984–991. https://doi.org/10.1038/jid.2014.530

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Min C, Kim M, Oh DJ, Choi HG (2020) Bidirectional association between psoriasis and depression: two longitudinal follow-up studies using a national sample cohort. J Affect Disord 262:126–132. https://doi.org/10.1016/j.jad.2019.10.043

    Article  PubMed  Google Scholar 

  24. Jalenques I, Bourlot F, Martinez E et al (2022) Prevalence and odds of anxiety disorders and anxiety symptoms in children and adults with psoriasis: systematic review and meta-analysis. Acta Derm Venereol 102:adv00769. https://doi.org/10.2340/actadv.v102.1386

    Article  PubMed  Google Scholar 

  25. Dowlatshahi EA, Wakkee M, Arends LR, Nijsten T (2014) The prevalence and odds of depressive symptoms and clinical depression in psoriasis patients: a systematic review and meta-analysis. J Invest Dermatol 134(6):1542–1551. https://doi.org/10.1038/jid.2013.508

    Article  CAS  PubMed  Google Scholar 

  26. Xiao Y, Zhang X, Luo D et al (2019) The efficacy of psychological interventions on psoriasis treatment: a systematic review and meta-analysis of randomized controlled trials. Psychol Res Behav Manag 12:97–106. https://doi.org/10.2147/PRBM.S195181

    Article  PubMed  PubMed Central  Google Scholar 

  27. Esposito M, Saraceno R, Giunta A, Maccarone M, Chimenti S (2006) An Italian study on psoriasis and depression. Dermatology 212(2):123–127. https://doi.org/10.1159/000090652

    Article  PubMed  Google Scholar 

  28. Soliman MM (2021) Depressive, anxiety, stress, and insomnia symptoms in patients with psoriasis: a cross-sectional study. Postepy Dermatol Alergol 38(3):510–519. https://doi.org/10.5114/ada.2020.98726

    Article  PubMed  Google Scholar 

  29. Jing D, Xiao H, Shen M et al (2021) Association of psoriasis with anxiety and depression: a case-control study in chinese patients. Front Med (Lausanne) 8:771645. https://doi.org/10.3389/fmed.2021.771645

    Article  PubMed  Google Scholar 

  30. Bakar RS, Jaapar SZS, Azmi AF, Aun YC (2021) Depression and anxiety among patients with psoriasis: a correlation with quality of life and associated factors. J Taibah Univ Med Sci 16(4):491–496. https://doi.org/10.1016/j.jtumed.2021.02.008

    Article  PubMed  PubMed Central  Google Scholar 

  31. Torales J, Echeverría C, Barrios I et al (2020) Psychodermatological mechanisms of psoriasis. Dermatol Ther 33(6):e13827. https://doi.org/10.1111/dth.13827

    Article  PubMed  Google Scholar 

  32. Zafiriou E, Daponte AI, Siokas V, Tsigalou C, Dardiotis E, Bogdanos DP (2021) Depression and obesity in patients with psoriasis and psoriatic arthritis: is IL-17-mediated immune dysregulation the connecting link? Front Immunol 12:699848. https://doi.org/10.3389/fimmu.2021.699848

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Koo J, Marangell L, b., Nakamura M, et al (2017) Depression and suicidality in psoriasis: review of the literature including the cytokine theory of depression. J the Eur Acad Dermatol Venereol 31(12):1999–2009. https://doi.org/10.1111/jdv.14460

    Article  CAS  Google Scholar 

  34. Wang X, Li Y, Wu L et al (2021) Dysregulation of the gut-brain-skin axis and key overlapping inflammatory and immune mechanisms of psoriasis and depression. Biomed Pharmacother 137:111065. https://doi.org/10.1016/j.biopha.2020.111065

    Article  CAS  PubMed  Google Scholar 

  35. Olejniczak-Staruch I, Ciążyńska M, Sobolewska-Sztychny D, Narbutt J, Skibińska M, Lesiak A (2021) Alterations of the skin and gut microbiome in psoriasis and psoriatic arthritis. Int J Mol Sci 22(8):3998. https://doi.org/10.3390/ijms22083998

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Simpson CA, Diaz-Arteche C, Eliby D, Schwartz OS, Simmons JG, Cowan CSM (2021) The gut microbiota in anxiety and depression—a systematic review. Clin Psychol Rev 83:101943. https://doi.org/10.1016/j.cpr.2020.101943

    Article  PubMed  Google Scholar 

  37. Collins SM, Surette M, Bercik P (2012) The interplay between the intestinal microbiota and the brain. Nat Rev Microbiol 10(11):735–742. https://doi.org/10.1038/nrmicro2876

    Article  CAS  PubMed  Google Scholar 

  38. Davey Smith G, Holmes MV, Davies NM, Ebrahim S (2020) Mendel’s laws, Mendelian randomization and causal inference in observational data: substantive and nomenclatural issues. Eur J Epidemiol 35(2):99–111. https://doi.org/10.1007/s10654-020-00622-7

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We thank the investigators of original genome-wide association study who provided the summary statistics.

Funding

This work was supported by a grant from the National Natural Science Foundation of China (NO.82074445).

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Author notes

  1. Saisai Liu and Kezhen Yang have contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Beijing University of Chinese Medicine, Beijing, China

    Saisai Liu, Kezhen Yang & Huachao Zhang

  2. China-Japan Friendship Hospital, No.2, Sakurakuen East Street, Beijing, 10029, China

    Saisai Liu, Huachao Zhang & Yanping Bai

  3. Weihaiwei People’s Hospital, No.70, North Qingdao Road, Weihai, 264200, Shandong, China

    Qingqing Yang

  4. Weihai Municipal Hospital, Shandong, China

    Saisai Liu

  5. Department of Rehabilitation Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China

    Kezhen Yang

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Contributions

S. Liu and K. Yang designed the experimental protocol and wrote the main manuscript text. H. Zhang Performed database screening. Q. Yang and Y.Bai Provided expertise and guidance on key technologies. All authors reviewed the manuscript.

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Correspondence to Qingqing Yang or Yanping Bai.

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Liu, S., Yang, K., Zhang, H. et al. The bidirectional causal association between psoriasis and psychological illnesses: a 2-sample Mendelian randomization study. Arch Dermatol Res 316, 40 (2024). https://doi.org/10.1007/s00403-023-02736-w

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