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Psoriasis, Depression, and Inflammatory Overlap: A Review

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Abstract

Psoriasis has an enormous impact on patients’ lives and is frequently associated with depression. Depression in psoriasis may be attributed, at least in part, to elevated proinflammatory cytokines rather than the psychosocial impact of psoriasis itself. Biologics that target inflammatory cytokines treat the clinical manifestations of psoriasis, but may also play a role in reducing associated depression. Multiple biologics have decreased symptoms of depression during clinical trials in psoriasis; however, these studies used a variety of depression screening tools, which limits comparison. Furthermore, it is difficult to distinguish whether improved depression is the result of the direct anti-inflammatory effect of the biologic, or the indirect effect of improved psoriasis leading to better psychological status. Future studies evaluating depression in patients with psoriasis could benefit from a standardized depression screening tool to mitigate discrepancies and facilitate comparison across treatment types. Here, we highlight the inflammatory overlap between psoriasis and depression by examining the pathophysiology of depression, and reviewing psoriasis clinical studies that assessed depression as an outcome measure.

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Authors and Affiliations

  1. Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1071, USA

    Nupur Patel, Anish Nadkarni, Leah A. Cardwell, Nora Vera, Casey Frey, Nikhil Patel & Steven R. Feldman

  2. Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Steven R. Feldman

  3. Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Steven R. Feldman

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  1. Nupur Patel
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Correspondence to Leah A. Cardwell.

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No sources of funding were used for the preparation of this article.

Conflict of interest

Dr. Feldman is a speaker for Janssen and Taro and a consultant and speaker for Galderma, Stiefel/GlaxoSmithKline, Abbott Labs, and Leo Pharma Inc. Dr. Feldman has received grants from Galderma, Janssen, Abbott Labs, Amgen, Stiefel/GlaxoSmithKline, Celgene, and Anacor. He is a consultant for Amgen, Baxter, Caremark, Gerson Lehrman Group, Guidepoint Global, Hanall Pharmaceutical Co Ltd, Kikaku, Lilly, Merck & Co Inc., Merz Pharmaceuticals, Mylan, Novartis Pharmaceuticals, Pfizer Inc., Qurient, Suncare Research, and Xenoport. He is on an advisory board for Pfizer Inc. Dr. Feldman is the founder and holds stock in Causa Research and holds stock and is the majority owner in Medical Quality Enhancement Corporation. He receives Royalties from UpToDate and Xlibris. Nupur Patel, Anish Nadkarni, Leah Cardwell, Nora Vera, Casey Frey, and Nikhil Patel have no conflicts directly relevant to the content of this article.

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Patel, N., Nadkarni, A., Cardwell, L.A. et al. Psoriasis, Depression, and Inflammatory Overlap: A Review. Am J Clin Dermatol 18, 613–620 (2017). https://doi.org/10.1007/s40257-017-0279-8

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