Forty five Patients with moderate to severe psoriasis were assessed for depression symptoms at baseline and week 24 using the Zung Self-rating Depression Scale (ZDS). Reductions in depression symptoms were significantly correlated with reductions in psoriasis severity. Both studies show strong correlations between disease severity and work disability. Reductions in anxiety and depression scores have also been demonstrated with ustekinumab (an anti-IL-12/23 agent used to treat psoriasis) 78. Psychological outcomes were not evaluated and patient numbers were small. Effect of biologics on depressive symptoms in patients with psoriasis: a systematic review. Adalimumab, etanercept and ustekinumab were associated with statistically significant reductions in depressive symptom scores using various scales in patients with moderate-to-severe psoriasis. Adalimumab, etanercept and ustekinumab were associated with statistically significant reductions in depressive symptom scores using various scales in patients with moderate-to-severe psoriasis.
Evidence that improvement in mood decreases psoriasis severity underscores how psychological awareness can be critical to clinicians in their practice. While decreases in fatigue were correlated with decreased joint pain, improvements in depressive symptoms were less correlated with psoriasis and arthritis severity, suggesting the presence of an alternative mechanism to explain this particular effect: potentially the physiologic changes associated with decreased systemic inflammation as opposed to the psychological effects of decreased psoriasis severity. Nighttime melatonin levels have been recorded to be significantly lower in patients with psoriasis than in healthy controls 64. As reduced kidney function is common in older individuals, consider using only low doses of methotrexate in these individuals, with close monitoring for toxicity. Severe psoriasis was associated with a higher risk of depression than mild psoriasis (72 and 38, respectively; hazard ratio HR 1. Depression symptoms were significantly more likely to improve in adalimumab responders ( PASI 75 at week 12 or termination of therapy) than in nonresponders (Table 2). There were no statistical differences between placebo and biologics for the occurrence of infections and serious adverse events. Only RCTs that evaluated the treatment of moderate to severe psoriasis with biological agents versus placebo were included. For the PASI 90 outcome, it appears that there is no statistically significant difference between placebo and etanercept 25mg OW. The effect of adalimumab on reducing depression symptoms in patients with moderate to severe psoriasis: a randomized clinical trial.
The QoL of children with psoriasis was more reduced than that of children with enuresis, diabetes and epilepsy (Beattie and Lewis-Jones 2006a). Quality of life and disease severity in children may be correlated (Ben-Gashir et al. (2009) found out that children with severe atopic dermatitis showed a significant delayed social development in their further course of life. A study screening 265 patients with psoriasis for depressive symptoms revealed a rate of 32 of patients with a positive screening for depression (Schmitt and Ford 2007). The most serious side effects were lymphopenia, malignancies, serious infections requiring hospitalization, and allergic reactions. The authors concluded that alefacept is ineffective for the treatment of severe AA. Patients experienced a significant reduction in the signs and symptoms of their disease at 16 weeks when treated with adalimumab. Mental health was assessed using the Hospital Anxiety and Depression Scale (HADS), with a total possible score of 0 42 (higher scores representing worse mental health). Reductions in disease severity improve self-assessed mood and anxiety disorders in patients with moderate to severe psoriasis. 6,7 Symptoms of anxiety and depression are common,5 8 but the severity of psychological outcomes is better correlated with self-assessed severity measures of the disease. A total of 1217 patients with moderate to severe psoriasis were recruited.
Exploring The Physiological Link Between Psoriasis And Mood Disorders
The extent to which the susceptibility is increased will likely differ between individuals based on underlying depression risk, differing levels and timing of exposure to cigarette smoke (for example, childhood versus adulthood) and presence and severity of cigarette-related health and social consequences. LPS in depression are significantly and positively correlated to plasma lysozyme, serum oxidized LDL antibodies and the IgM responses directed against azelaic acid and malondialdehyde and phosphatidylinsositol, and NO-adducts, such as NO-tryptophan and NO-tyrosine 140. Depression is a state of low mood and aversion to activity that can affect a person’s thoughts, behavior, feelings and sense of well-being. Certain medications are known to cause depressed mood in a significant number of patients. These include major depressive disorder (MDD; commonly called major depression or clinical depression) where a person has at least two weeks of depressed mood or a loss of interest or pleasure in nearly all activities; and dysthymia, a state of chronic depressed mood, the symptoms of which do not meet the severity of a major depressive episode. Depression and organic factors appear to play a key role in this relation.