Artikel
Depressive symptoms are frequent, associated with disease severity, and affect quality of life in psoriasis and psoriatic arthritis: A questionnaire-based assessment of 300 patients
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Veröffentlicht: | 8. Oktober 2019 |
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Gliederung
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Background: Psoriasis (PSO) and psoriatic arthritis (PsA) have both been associated with depression. It has been established that depression may lead to a reduced compliance as well as increased symptom load and disability in chronic conditions. Depression thus constitutes an important comorbidity in inflammatory joint conditions and may significantly impact quality of life (QOL). Here, we sought to determine factors associated with signs of depression and QOL.
Methods: A set of questionnaires (PEST, FFbH, WHOQOL-BREF, Phq9, GHQ-12) was used to assess patients with PSO or PsA for quality of life, signs of depression and associated factors.
Results: We have assessed 150 psoriasis patients as well as 150 patients with confirmed psoriatic arthritis for quality of life, signs of depression and associated factors. Physical health-related QOL was significantly reduced in PsA patients compared to patients with PSO only (p<0.001). Overall perceived QOL and satisfaction with health did not differ significantly in both groups. PsA patients had a significantly higher score on Phq9 questionnaire measuring symptoms of depression (p=0.028). Depressive symptoms conversely showed a strong negative correlation with QOL (p<0.001). Patient age was significantly correlated with physical-health related QOL as well as with perceived QOL (p=0.002, respectively p=0.007), however, not with signs of depression. Interestingly, duration of disease neither correlated with functional impairment in everyday life, quality of life, or depressive symptoms (p=0.559, p=0.704, respectively p=0.093). There was no significant difference between male and female patients regarding quality of life or depressive symptoms. Pain correlated highly with depressive symptoms (p<0.001). The number of affected joint regions also correlated highly with perceived QOL as well as with depressive symptoms (both p<0.001). C-reactive protein (CRP) serum concentrations correlated with perceived QOL (p=0.003), but not with depressive symptoms (p=0.564).
Conclusion: Depressive symptoms have a high prevalence in both PSO and PsA patients and contribute to a significant reduction of QOL. Our data indicate an association of pain with depressive symptoms underlining the importance of adequate treatment to avoid psychological comorbidity.