Indian Journal of Private Psychiatry

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VOLUME 14 , ISSUE 2 ( July-December, 2020 ) > List of Articles

Original Article

Prevalence of Psychiatric Comorbidities in Patients with Psoriasis: A Cross-sectional Study from a Tertiary Care Hospital in Eastern India

Benugopal Mohapatra, Neloy Sinha, Avijit Mondal, Partha Mukherjee, Moumita Chatterjee

Keywords : Anxiety, Depression, Psoriasis, Psychiatric comorbidities

Citation Information : Mohapatra B, Sinha N, Mondal A, Mukherjee P, Chatterjee M. Prevalence of Psychiatric Comorbidities in Patients with Psoriasis: A Cross-sectional Study from a Tertiary Care Hospital in Eastern India. Ind J Priv Psychiatry 2020; 14 (2):68-74.

DOI: 10.5005/jp-journals-10067-0064

License: CC BY-NC 4.0

Published Online: 31-07-2021

Copyright Statement:  Copyright © 2020; The Author(s).


Abstract

Background: Psoriasis has been known to be associated with various psychiatric comorbidities like depression, anxiety, adjustment disorder, persistent stress, and impaired sexual and marital life. Aim: The aim of this study was to find out the prevalence of psychiatric comorbidities in patients with psoriasis. Methods: One hundred and forty-nine consecutive patients with psoriasis fulfilling the inclusion criteria got examined by a senior consultant dermatologist. Sociodemographic and clinical pro forma were filled in. Following informed consent, the patients were assessed for severity of the condition by Psoriasis Area and Severity Index score and were screened for the presence of psychiatric comorbidities by a validated Bengali version of the screening tool Self-Reporting Questionnaire 20 (SRQ 20). Subjects were administrated in succession with Bengali version of Self-Reporting BDI (Beck Depression Inventory) (already validated), Hamilton Anxiety Scale, and SKINDEX 61 (interviewer-rated) for evaluating the depression, anxiety, and psychiatric morbidities under the guidance of a consultant psychiatrist. Results: In index study, a majority of the subjects (98%) had a mild degree of anxiety symptoms. In BDI, the majority of the subjects had minimal depression, whereas near about two-fifths of the subjects had mild to severe depression. As per SRQ assessment of psychopathology, the majority of subjects (57.71%) had psychiatric disorder. Around two-thirds male and half of the female subjects, respectively, were SRQ positive. On SKINDEX-61, the majority of the subjects responded affirmatively in a decreasing order of frequency in the following domains: embarrassment, discomfort, fear, anger, physical limitation, depression, and cognitive impairment. Severity of psoriasis had a significant positive correlation with depression severity grades and the presence or absence of psychopathology. The index study also revealed that the number of body sites involved in psoriasis had a significant positive correlation with depression severity. Conclusion: Psoriasis was associated with significant psychiatric comorbidities, and those need to be addressed.


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  1. Christophers E. Psoriasis – epidemiology and clinical spectrum. Clin Exp Dermatol 2001;26(4):314–320. DOI: 10.1046/j.1365-2230.2001.00832.x.
  2. Ambady BM, Gopinath T, Nair BKH. Psoriasis. Indian J Dermatol Venereol 1961;23:27–34. PMID: 29244275.
  3. Dogra S, Yadav S. Psoriasis in India: prevalence and pattern. Indian J Dermatol Venereol Leprol 2010;76(6):595–601. DOI: 10.4103/0378-6323.72443.
  4. Raychaudhuri SP, Gross J. A comparative study of paediatric onset psoriasis with adult onset psoriasis. Pediatr Dermatol 2000;17(3):174–178. DOI: 10.1046/j.1525-1470.2000.01746.x.
  5. Farber EM, Nall ML. The natural history of psoriasis in 5600 patients. Dermatologica 1974;148(1):1–18. DOI: 10.1159/000251595.
  6. Augustin M, Glaeske G, Radtke MA, et al. Epidemiology and comorbidity of psoriasis in children. Br J Dermatol 2010;162(3):633–636. DOI: 10.1111/j.1365-2133.2009.09593.x.
  7. Sarkar S, Sarkar A, Saha R, et al. Psoriasis and psychiatric morbidity: a profile from a tertiary care centre of eastern India. J Family Med Prim Care 2014;3(1):29–32. DOI: 10.4103/2249-4863.130267.
  8. Lakshmy S, Balasundaram S, Sarkar S, et al. A cross-sectional study of prevalence and implications of depression and anxiety in psoriasis. Indian J Psychol Med 2015;37(4):434–440. DOI: 10.4103/0253-7176.168587.
  9. Gupta MA, Gupta AK. Psychiatric and psychological co-morbidity in patients with dermatologic disorders: epidemiology and management. Am J Clin Dermatol 2003;4(12):833–842. DOI: 10.2165/00128071-200304120-00003.
  10. Nasreen S, Ahmed I, Effendi S. Frequency and magnitude of anxiety and depression in patients with psoriasis vulgaris. J Coll Physicians Surg Pak 2008;18(7):397–400. PMID: 18760060.
  11. Han C, Lofland JH, Zhao N, et al. Increased prevalence of psychiatric disorders and health care-associated costs among patients with moderate-to-severe psoriasis. J Drugs Dermatol 2011;10(8):843–850. PMID: 21818505.
  12. Rabin F, Bhuiyan SI, Islam T, et al. Psychiatric and psychological comorbidities in patients with psoriasis – a review. Mymensingh Med J 2012;21(4):780–786. PMID: 23134936.
  13. Grozdev I, Kast D, Cao L, et al. Physical and mental impact of psoriasis severity as measured by the compact Short Form-12 Health Survey (SF-12) quality of life tool. J Invest Dermatol 2012;132(4):1111–1116. DOI: 10.1038/jid.2011.427.
  14. Mc Donough E, Ayearst R, Eder L, et al. Depression and anxiety in psoriatic disease: prevalence and associated factors. J Rheumatol 2014;41(5):887–896. DOI: 10.3899/jrheum.130797.
  15. Chamoun A, Goudetsidis L, Poot F, et al. Psoriasis and depression. Rev Med Brux 2015;36(1):23–28. PMID: 25856968.
  16. Khawaja AR, Bokhari SM, Tariq R, et al. Disease severity, quality of life, and psychiatric morbidity in patients with psoriasis with reference to sociodemographic, lifestyle, and clinical variables: a prospective, cross-sectional study from Lahore, Pakistan. Prim Care Companion CNS Disord 2015;17(3). DOI: 10.4088/PCC.14m01629.
  17. Pompili M, Innamorati M, Trovarelli S, et al. Suicide risk and psychiatric comorbidity in patients with psoriasis. J Int Med Res 2016;44 (1 suppl):61–66. DOI: 10.1177/0300060515593253.
  18. Lamb RC, Matcham F, Turner MA, et al. Screening for anxiety and depression in people with psoriasis: a cross-sectional study in a tertiary referral setting. Br J Dermatol 2017;176(4):1028–1034. DOI: 10.1111/bjd.14833.
  19. Tian Z, Huang Y, Yue T, et al. A Chinese cross-sectional study on depression and anxiety symptoms in patients with psoriasis vulgaris. Psychol Health Med 2019;24(3):269–280. DOI: 10.1080/13548506.2018.1529323.
  20. Tzur Bitan D, Krieger I, Comaneshter D, et al. The association between the socioeconomic status and anxiety-depression comorbidity in patients with psoriasis: a nationwide population-based study. J Eur Acad Dermatol Venereol 2019;33(8):1555–1561. DOI: 10.1111/jdv.15651.
  21. Naing L, Winn T, Rusli BN. Sample size calculator for prevalence studies, version 1.0.01. Available at: http://www.kck.usm.my/ppsg//stats_resource.htm.
  22. British Association of Dermatologists. Psoriasis area and severity index (PASI) worksheet. Available at: http://www.bad.org.uk/shared/get-file.ashx?id=1654&itemtype=document [Accessed on 10/09/18].
  23. Hamilton M. The assessment of anxiety states by rating. Br J Psychiatry 1959;32(1):50–55. DOI: 10.1111/j.2044-8341.1959.tb00467.x.
  24. Beck AT, Ward C, Mendelson M. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561–571. DOI: 10.1001/archpsyc.1961.01710120031004.
  25. Beusenberg M, Orley JH, World Health Organization. Division of Mental Health. A User's guide to the self-reporting questionnaire (SRQ/compiled by M. Beusenberg and J. Orley. Geneva, Switzerland: World Health Organization; 1994.
  26. Chren MM, Lasek RJ, Quinn LM, et al. Skindex, a quality-of-life measure for patients with skin disease: reliability, validity, and responsiveness. J Invest Dermatol 1996;107(5):707–713. DOI: 10.1111/1523-1747.ep12365600.
  27. IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.
  28. Brodaty H, Luscombe G, Parker G, et al. Increased rate of psychosis and psychomotor change in depression with age. Psychol Med 1997;27(5):1205–1213. DOI: 10.1017/s0033291797005436.
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