Association between psoriasis and depression

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Blood based systemic inflammatory biomarkers are an easily accessible and cost effective tool for identifying psoriasis and partially mediating the association between psoriasis and depression.

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Background:
Psoriasis is a chronic relapsing systemic inflammatory disease with a high prevalence of psychiatric comorbidities, especially depression. However, the precise role of inflammation in the relationship between psoriasis and depression remains unclear.

Method:
We explored the association among psoriasis, systemic inflammatory biomarkers, and depression in a large, ethnically diverse sample from the 2009–2014 National Health and Nutrition Examination Survey (NHANES) data. Psoriasis was estimated by the questionnaire. Depression was evaluated using the 9-item Patient Health Questionnaire (PHQ-9). Systemic inflammation response index (SIRI) and neutrophil-to-lymphocyte ratio (NLR) were determined using the examination data. Meanwhile, multivariable logistic and linear regression analyses explored the relationship between psoriasis, systemic inflammatory markers, and depression. On the basis of restricted cubic spline (RCS) regression, we further explored the potential linear relationship between systemic inflammatory biomarkers and depression. Finally, a mediation model was established to explain the intermediary role of systemic inflammatory biomarkers in this relationship.

Result:
Among the 12,734 participants in this study, 1172 participants had a depression score ≥ 10. After full adjustment, psoriasis was positively associated with depression and systemic inflammatory markers (for depression, OR [95% CI]: 2.000 [1.500, 2.668]; for LnSIRI, β [95% CI]: 0.091 [0.033, 0.150]; for LnNLR, β [95% CI]: 0.053 [0.006, 0.099]). Meanwhile, systemic inflammatory marker levels were linearly associated with depression (LnSIRI: Pnon-linear = 0.696; LnNLR: Pnon-linear = 0.921). Further mediation analysis indicated that SIRI and NLR mediated a marginal portion of the potential effects of psoriasis on depression, with proportions of 1.64% and 2.00%, respectively.

Conclusion:
Psoriasis is a risk factor for depression. Blood-based systemic inflammatory biomarkers are an easily accessible and cost-effective tool for identifying psoriasis and partially mediating the association between psoriasis and depression. It may provide important insights into guiding anti-inflammatory treatment strategies to prevent depression.

Source: onlinelibrary.wiley.com

*Funding: No funding received