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Psoriasis can affect mental health of patient
Dermatologists often approach patients having the condition of psoriasis by focussing mainly on the visible symptoms present on their skin. But several neuro-immunological studies seem to suggest that this condition may require a multidimensional approach for its treatment.
By
migrator
migrator
Chennai
We have known for some time that psoriasis can affect the skin, as well as the joints, and increase a person’s susceptibility to other medical conditions as well. But recent research is making it clear that psoriasis can also have an impact on a patient’s mental health.
The latest joint guideline by the American Academy of Dermatology and National Psoriasis Foundation (AAD-NPF) address the increased risk of depression in patients with psoriasis and the need to manage it.
Doctors say that patients with psoriasis are at least 1.5 times more likely to have depression that those without psoriasis. Another study has estimated that 1 out of 6 patients with psoriasis also has depression.
An increase in depressive symptoms is linked to the worsening of psoriasis, and vice versa. Dermatologists are usually the primary point of contact for a skin condition such as psoriasis.
This means that we are well placed to be the first to caution patients about the possible impact of this condition on their mental health, detect any change in mental symptoms and help them get the help they need.
The molecular connection
Senior Consultant and Coordinator- Dermatology, Dr Murlidhar Rajgopalan, Apollo hospitals say that depression and psoriasis are not merely “coincidental comorbidities.”
The two conditions are linked at the molecular level through common inflammatory mechanisms as well as psychologically. The same pro-inflammatory cytokines that cause psoriatic lesions in patients also increase depression.
For instance, interleukin 6 promotes the production of T helper that plays a crucial role in the development of psoriasis lesions along with tumour necrosis factor α. At the same time, increased levels of IL-6 and TNF α are seen in depression and play a role in triggering symptoms.
The gene mutations seen in psoriasis are also linked to pro-inflammatory cytokines that may lead to depressive disorder. Low levels of circulating melatonin have also been linked to both conditions.
“During a psoriatic flare, patients develop patches on different parts of their body or head that may be visible. The visual appearance of these patches can be disturbing to the patient and others.
For the patient, this can result in a loss of self-esteem and confidence, particularly if the person is employed in a place where he or she needs to interact with other people.
Additionally, the general public is often misinformed about psoriasis and fear that they may ‘catch it’ from close contact with the patient,” said Dr Murlidhar.
This can cause them to distance themselves from a patient or exclude the patient from social outings. All of this can have a tremendous negative impact on the mental health of a person and trigger anxiety, depression and even suicidal ideation.
Moreover, depression itself can act as a trigger or worsen psoriatic flares. All of this can lead to a vicious cycle that can severely affect the patient’s quality of life, unless correctly addressed and treated.
Reasons For Depression
- Visible patches on hands and neck will be disturbing to the patient
- Psoriasis patients often lose their confidence and self esteem
- They fear that social circle would reduce as they may fear of contracting the condition
- Increased depression results in more psoriatic flares that may end in suicide
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