Lesion area reduction and the amelioration of anxiety and depression states in psoriasis patients: A prospective clinical study

Abstract

Background: Psoriasis patients are more likely to have mental disorders. The relationship between the reduction of involvement area and severity of lesions and the associated improvement in anxiety and depression in psoriasis patients, remains inadequately researched.

Methods: 200 psoriasis patients were enrolled in this prospective study, and received 12-week narrowband ultraviolet B (NB-UVB) therapy. The Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA), and Physician Global Assessment (PGA) scores were obtained as the objective assessments of disease, each reflecting distinct aspects of the disease. The Hospital Anxiety and Depression Scale (HADS) was used to evaluate the anxiety and depression symptoms.

Results: Successful treatment brought an improvement in anxiety and depression levels and rates (all p < 0.05). Statistical analysis revealed no significant improvements in the scores of HADS or rates of symptomatic anxiety and depression in patients who did not achieve a PASI 75 response (all p > 0.05). Reductions in PASI, BSA and PGA were all statistically associated with reductions in HADS (all p < 0.05). BSA 75 response was found to play a more crucial role in the transition of symptomatic psoriatic patients to asymptomatic status (all p < 0.01).

Limitations: The study focused on the short-term effects, and further research is needed to investigate the long-term effects.

Conclusion: Successful treatment of psoriasis resulted in improvements in anxiety and depression levels and rates. In comparison with the lesion severity, reduction in the lesion involvement area had a greater impact on the anxiety and depression symptoms.

Keywords: Anxiety; Depression; Mental health; Phototherapy; Psoriasis.