Depression and quality of life in psoriasis and psoriatic arthritis patients

Background: Psoriasis is a chronic hyperproliferative disease of the skin, scalp, nails, and joints that affects 2% of the general population. One of the extracutaneous manifestations of psoriasis is psoriatic arthritis which occurs in 25–34% of the psoriasis cases. This type of inflammatory arthritis is characterized by pain, swelling, and tenderness around the joints, and may adversely affect patient’s functional abilities and the quality of life. Objectives: To evaluate depression and quality of life in Iranian patients with psoriasis and psoriatic arthritis. Materials and methods: From January 2009 to January 2010, 100 psoriasis patients who were randomly selected (through simple random selection) from the outpatient clinic of Razi Hospital and did not have any other skin or autoimmune diseases were asked to answer valid and reliable instruments such as the Beck Depression Inventory (BDI), SF-36, and DLQI (Dermatology Life Quality Index). Results: Mean scores of the BDI, SF-36, and DLQI of all the patients were 17.1 ± 12.3, 59.8 ± 19.5, and 12.4 ± 6.1, respectively. The most common type of the disease was the plaque type in eighty eight cases. Thirty-one women and 26 men were depressed (P = 0.06), and depressed individuals had higher DLQI scores (14.2 ± 5.5 vs. 9.9 ± 6.2, r = 0.3 P = 0.001). Patients with arthritis had significantly higher BDI and lower SF-36 scores suggesting more severe depression and quality of life impairment than those without arthritis. Conclusions: Extracutaneous manifestations of psoriasis and mood disorders should be considered in psoriatic patients to address the risk of markedly impaired quality of life.