Association between psoriasis and depression

[Fred]

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

[Caroline]

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Blood based systemic inflammatory biomarkers are an easily accessible and cost effective tool for identifying psoriasis

We knew that already of course, but they are the complex markers I think, this is not clear in this abstract. 
But we know that if you see excess IL-23 and IL-17, and you have plaques than probably you have psoriasis. 

"Partially mediating"  is a vague term.. 
"However, the precise role of inflammation in the relationship between psoriasis and depression remains unclear." conclusion.. they don't know..

And that there is a relation between psoriasis and depression.....

What do you think ?
There are visible red/white plaques on your skin and skin is falling off. People look at you often with disgust, Children look at you and say " Ieuwwww"...
you get sent out of the swimming pool.
Do you think that that does mean nothing to you psychic condition?

I think depression is obvious.. No need to try to find biomarkers for it... , but maybe details of this research give better reasons.

[Fred]

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The inflammatory hypothesis has been proposed to explain the potential association between psoriasis and depression. Several retrospective studies suggested that the standard of assorted inflammatory cytokines and cells is significantly elevated in psoriasis patients compared to the normal population. Meanwhile, a prospective longitudinal observational research indicated that psoriasis patients with systemic treatment had a prominent reduction in the blood inflammatory parameters. In addition, previous researches find inflammation is essential for the pathogenesis of depression. The exacerbation of inflammation contributes to its development and worsening. A clinical study found that nearly half of all cancer patients suffer from mood disturbances after taking interferon-alpha, especially depression. Antidepressant treatment also significantly reduces the level of inflammation in patients with depression. Meanwhile, anti-inflammatory therapy can improve antidepressant effectiveness and alleviate depressive symptoms, but the potential relationship between inflammation and depression remains unclear.

Nevertheless, the role of inflammation remains poorly understood in the relationship between psoriasis and depression. The study analyzed the humongous multiracial adult cohort to investigate whether inflammation is involved in the relevance between psoriasis and depression. Inflammatory reactions contribute to changes in the quantity and category of circulating immunocytes. Neutrophils, lymphocytes, and monocytes are essential in regulating the inflammatory response. Neutrophils serve a vital function in innate immunity and are involved in releasing cytokine, phagocytosis, and apoptosis in acute inflammation. Lymphocytes are key cells that connect innate and adaptive responses. Monocytes have a significant role in the innate immune system and coordinating inflammation. The neutrophil-to-lymphocyte ratio (NLR) is an easily measurable clinical biomarker that can reflect inflammation levels from a complete blood count (CBC). Moreover, the systemic inflammation response index (SIRI) is an innovative inflammatory biomarker. This biomarker is derived from the analysis of various immune cell subsets, along with the quantification of monocyte counts. Thus, the study chose NLR and SIRI as the systemic inflammatory biomarkers.

We aimed to explore the mediating role of SIRI and NLR in the association between psoriasis and depression. Therefore, this study was mainly validated around two key hypotheses: (1) There was a significant correlation between psoriasis, systemic inflammatory markers, and depression; (2) systemic inflammatory markers may serve as a partial mediator in the relationship between psoriasis and depression.

[Caroline]

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The inflammatory hypothesis has been proposed to explain the potential association between psoriasis and depression. Several retrospective studies suggested that the standard of assorted inflammatory cytokines and cells is significantly elevated in psoriasis patients compared to the normal population. Meanwhile, a prospective longitudinal observational research indicated that psoriasis patients with systemic treatment had a prominent reduction in the blood inflammatory parameters. In addition, previous researches find inflammation is essential for the pathogenesis of depression. The exacerbation of inflammation contributes to its development and worsening. A clinical study found that nearly half of all cancer patients suffer from mood disturbances after taking interferon-alpha, especially depression. Antidepressant treatment also significantly reduces the level of inflammation in patients with depression. Meanwhile, anti-inflammatory therapy can improve antidepressant effectiveness and alleviate depressive symptoms, but the potential relationship between inflammation and depression remains unclear.

Nevertheless, the role of inflammation remains poorly understood in the relationship between psoriasis and depression. The study analyzed the humongous multiracial adult cohort to investigate whether inflammation is involved in the relevance between psoriasis and depression. Inflammatory reactions contribute to changes in the quantity and category of circulating immunocytes. Neutrophils, lymphocytes, and monocytes are essential in regulating the inflammatory response. Neutrophils serve a vital function in innate immunity and are involved in releasing cytokine, phagocytosis, and apoptosis in acute inflammation. Lymphocytes are key cells that connect innate and adaptive responses. Monocytes have a significant role in the innate immune system and coordinating inflammation. The neutrophil-to-lymphocyte ratio (NLR) is an easily measurable clinical biomarker that can reflect inflammation levels from a complete blood count (CBC). Moreover, the systemic inflammation response index (SIRI) is an innovative inflammatory biomarker. This biomarker is derived from the analysis of various immune cell subsets, along with the quantification of monocyte counts. Thus, the study chose NLR and SIRI as the systemic inflammatory biomarkers.

We aimed to explore the mediating role of SIRI and NLR in the association between psoriasis and depression. Therefore, this study was mainly validated around two key hypotheses: (1) There was a significant correlation between psoriasis, systemic inflammatory markers, and depression; (2) systemic inflammatory markers may serve as a partial mediator in the relationship between psoriasis and depression.

I read it indeed... it suggests that there is a relationship between inflammation and depression. I am not surprised that cancer patients often have depression. And in the last sentence of paragraph one: " but the potential relationship between inflammation and depression remains unclear." Which makes all of the above.............."

Next paragraph starts with: "Nevertheless, the role of inflammation remains poorly understood in the relationship between psoriasis and depression. "
The next seems all true to me, but has nothing to do with depression, but inflammation.

The last paragraph says: "There was a significant correlation between psoriasis, systemic inflammatory markers, and depression" , but who says this relation is not just common psychological ???? Which is more obvious to me..

[Fred]

Don't know sorry, all I know is I got depression before psoriasis so it doesn't work for me.

[Caroline]

Don't know sorry, all I know is I got depression before psoriasis so it doesn't work for me.

And for me.... I don't have depression at all.....

[Fred]

Don't know sorry, all I know is I got depression before psoriasis so it doesn't work for me.

And for me.... I don't have depression at all..... 

I don't now thanks to Mrs Fred

[Caroline]

Don't know sorry, all I know is I got depression before psoriasis so it doesn't work for me.

And for me.... I don't have depression at all..... 

I don't now thanks to Mrs Fred

For Mrs. Fred