Evidence for a causal association between psoriasis and psychiatric disorders using a bidirectional Mendelian randomization analysis in up to 902,341 individuals

Yujie Wang; Xinquan Wang; Xiaoyu Gu; Jie Pan; Zhen Ouyang; Wenrui Lin; Wu Zhu; Mi Wang; Juan Su

doi:10.1016/j.jad.2023.05.059

Evidence for a causal association between psoriasis and psychiatric disorders using a bidirectional Mendelian randomization analysis in up to 902,341 individuals

J Affect Disord. 2023 Sep 15:337:27-36. doi: 10.1016/j.jad.2023.05.059. Epub 2023 May 24.

Authors

Yujie Wang¹, Xinquan Wang¹, Xiaoyu Gu¹, Jie Pan¹, Zhen Ouyang¹, Wenrui Lin¹, Wu Zhu², Mi Wang³, Juan Su⁴

Affiliations

¹ Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
² Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China. Electronic address: zhuwu70@hotmail.com.
³ Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; Department of Mental Health Center, Xiangya Hospital, Central South University, Changsha, China. Electronic address: mi.wang@csu.edu.cn.
⁴ Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China. Electronic address: sujuanderm@csu.edu.cn.

PMID: 37230262
DOI: 10.1016/j.jad.2023.05.059

Abstract

Background: The causal association between psoriasis and psychiatric disorders remains ambiguous.

Objectives: This study aimed to investigate the causal relationship between psoriasis and common psychiatric disorders using bidirectional Mendelian randomization (MR) analysis.

Methods: Major depressive disorder (MDD) (N = 217,584), bipolar disorder (N = 51,710), schizophrenia (N = 77,096), and anxiety disorder (N = 218,792) were obtained as outcomes, and psoriasis (N = 337,159) were as exposure. Inverse variance weighting (IVW) was used as the main method, with other sensitivity methods as auxiliary methods. Sensitivity analysis and heterogeneity tests were performed to ensure the robustness of the results. We also performed a subgroup analysis of cases with psoriatic arthritis (PsA) (N = 213,879) by using the same testing methods.

Results: MR showed that the genetic risk of psoriasis was positively associated with bipolar disorder (odds ratio (OR) = 13.54, 95 % confidence interval (95%CI): 2.43-75.37, P = 0.002) and MDD (OR = 1.08, 95%CI: 1.01-1.15, P = 0.027), which indicated possible causal relationships between psoriasis and these two diseases. Schizophrenia (OR = 3.52, 95%CI: 0.22-55.71, P = 0.372) and anxiety disorders (OR = 0.65, 95%CI: 0.16-2.63, P = 0.546) indicated no significant causal association. No reverse causal effects of psychiatric disorders on psoriasis were found. Subgroup analysis also suggested causal association of PsA with the bipolar affective disorder (OR = 1.05, 95%CI: 1.01-1.08, P = 0.005).

Limitations: Potential pleiotropic effects, restriction to European populations, and differences in diagnostic criteria.

Conclusions: This study has supported the causal association of psoriasis with MDD and bipolar disorder, and the subtype PsA with bipolar disorder, which informed the intervention for mental illnesses in patients with psoriasis.

Keywords: Anxiety disorders; Bipolar disorder; Major depressive disorder; Mendelian randomization; Psoriasis; Schizophrenia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Arthritis, Psoriatic* / epidemiology
Arthritis, Psoriatic* / genetics
Depressive Disorder, Major* / epidemiology
Depressive Disorder, Major* / genetics
Genome-Wide Association Study
Humans
Mendelian Randomization Analysis
Mental Disorders* / epidemiology
Mental Disorders* / genetics
Polymorphism, Single Nucleotide
Psoriasis* / epidemiology
Psoriasis* / genetics