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Psoriasis can cause skin discomfort and social stigmatization. In adults, studies show that psoriasis may lead to decreased self-esteem and increased depression, anxiety, and suicide ideation (JW Dermatol Nov 19 2010 and Oct 2 2009). Because 30% of psoriasis begins in childhood, these investigators studied the risk for associated psychiatric disorders in the young.
Using information from a national database for a 6-year period, the researchers compared 7404 pediatric patients with newly diagnosed psoriasis and 37,020 control children with no history of psoriasis or psychiatric illness (53.7%, female; mean age at index date, 11.4 years, for both groups). Comorbid hyperlipidemia, obesity, hypertension, diabetes, and cardiovascular diseases were significantly more common in the psoriasis cohort than in the psoriasis-free controls, but prevalence was less than 2%. All subjects were followed from their index dates to first diagnosis of psychiatric disorder. Significantly more psoriasis patients than control patients (5.1% vs. 4.1%) were diagnosed with psychiatric disorders, especially depression and anxiety (P<0.0001). After adjusting for confounding factors, the psoriasis patients were 47% more likely than the control patients to receive a psychotropic medication, specifically antidepressants and anxiolytics.
Kimball AB et al. Risks of developing psychiatric disorders in pediatric patients with psoriasis. J Am Acad Dermatol 2012 Oct; 67:651. (http://dx.doi.org/10.1016/j.jaad.2011.11.948)
Comment
This large cohort study demonstrates that children and adolescents with psoriasis have a significantly increased risk for depression, anxiety, and other psychiatric disorders. Furthermore, the true risks may be even higher, as uninsured populations were not included in this database, and mental health issues are often not explored in the dermatology office visit.