Psoriasis, Psychotropic Drugs and Psychiatric Comorbidities: A Case-Control Study with Inpatients

  • Bárbara Roque Ferreira Médica Interna de Dermatologia e Venereologia/Resident, Dermatology and Venereology, Serviço de Dermatologia e Venereologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Luís Santiago Médico Interno de Dermatologia e Venereologia/Resident, Dermatology and Venereology, Serviço de Dermatologia e Venereologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • João Simões Médico Interno de Otorrinolaringologia/Resident, OtoRhinoLaryngology, Serviço de Otorrinolaringologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Leonor Ramos Assistente Hospitalar de Dermatologia e Venereologia/Consultant, Dermatology and Venereology, Serviço de Dermatologia e Venereologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Maria Manuel Brites Assistente Hospitalar Graduada de Dermatologia e Venereologia/Graduated Consultant, Dermatology and Venereology, Serviço de Dermatologia e Venereologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • José Pedro Reis Assistente Hospitalar Graduada de Dermatologia e Venereologia/Graduated Consultant, Dermatology and Venereology, Serviço de Dermatologia e Venereologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Américo Figueiredo Professor e Director do Serviço de Dermatologia/Professor and Head of Dermatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
Keywords: Comorbidity, Mental Disorders, Psoriasis, Psychotropic Drugs

Abstract

Introduction: Psoriasis is a chronic inflammatory dermatosis with significant impact on quality of life and multiple comorbidities, with recognition especially given to cardiovascular risk factors. Recently it has been highlighted the high prevalence of psychiatric comorbidities.

Methods: The primary outcome was to assess the prevalence of psychotropic drugs in the chronic medication of patients with diagnosis of psoriasis. We performed a case-control study at the Department of Dermatology of Coimbra Hospital and University Centre, between 2010 and 2015. The results were compared with age- and gender-matched controls. The medication was grouped according to the INFARMED. The secondary outcome was to compare the prevalence of treatments for cardiovascular risk factors in both groups and to compile the information on psychiatric comorbidities available in the medical records of the psoriasis patients included in this study. The data were processed by STATA 14 and statistical significance was considered when p<0.05. Results: The sample consisted of 79 patients, 67% male and 33% female, mean age of 59.30±17.17 years. There was association (p<0.01) between psoriasis and psychotropic drugs, especially anxiolytics and antipsychotics, with 63% of patients with at least one psychotropic drug. It was found an association between psoriasis and antihypertensive drugs (p<0.05). Frequently, psychiatric diagnoses were not mentioned or were inaccurately described in the medical records.

Conclusion: The results highlight the high prevalence of psychotropic drugs and reinforce previous studies about the lack of assessment of psychopathology in dermatology, a topic of high relevance in patients with psychodermatologic diseases, such as psoriasis.

Downloads

Download data is not yet available.

References

Coimbra S, Oliveira H, Figueiredo A, Rocha-Pereira P,

Santos-Silva A. Factors associated with the length of remission

of psoriasis vulgaris. Clin Drug Investig. 2013;

:855-60.

Ferreira BI, Abreu JL, Reis JP, Figueiredo AM. Psoriasis

and associated psychiatric disorders: a systematic review

on etiopathogenesis and clinical correlation. J Clin Aesthet

Dermatol. 2016; 9:36-43.

Hunter HJ, Griffiths CE, Kleyn CE. Does psychosocial

stress play a role in the exacerbation of psoriasis? Br J

Dermatol. 2013; 169:965-74.

Kumar S, Kachhawha D, Das Koolwal G, Gehlot S, Awasthi

A. Psychiatric morbidity in psoriasis patients: a pilot

study. Indian J Dermatol Venereol Leprol. 2011; 77:625.

Heller MM, Lee ES, Koo JY. Stress as an influencing factor

in psoriasis. Skin Therapy Lett. 2011; 16:1-4.

Kimball AB, Gieler U, Linder D, Sampogna F, Warren RB,

Augustin M. Psoriasis: is the impairment to a patient's

life cumulative? J Eur Acad Dermatol Venereol. 2010;

:989-1004.

Rapp SR, Feldman SR, Exum ML, Fleischer AB Jr, Reboussin

DM. Psoriasis causes as much disability as other

major medical diseases. J Am Acad Dermatol. 1999;

:401-7.

American Psychiatric Association. Diagnostic and Statistical

Manual of Mental Disorders.5th ed. Arlington: APA;

Chamoun A, Goudetsidis L, Poot F, Bourdeaud'hui F, Titeca

G. Psoriasis et depression. Rev Med Brux. 2015;

:23-8.

Fleming P, Bai JW, Pratt M, Sibbald C, Lynde C, Gulliver

WP. The prevalence of anxiety in patients with psoriasis:

a systematic review of observational studies and clinical

trials. J Eur Acad Dermatol Venereol. 2016 (in press).

Evers AW, Verhoeven EW, Kraaimaat FW, de Jong EM, de

Brouwer SJ, Schalkwijk J, et al. How stress gets under the

skin: cortisol and stress reactivity in psoriasis. Br J Dermatol.

; 163:986-91.

Mizara A, Papadopoulos L, McBride SR. Core beliefs

and psychological distress in patients with psoriasis

and atopic eczema attending secondary care: the role

of schemas in chronic skin disease. Br J Dermatol. 2012;

:986-93.

Torres-Hernández M, López-García S, Pedroza-Escobar

D, Escamilla-Tilch M. The role of alexithymia as a psychosomatic

factor in psoriasis. Rev Med Inst Mex Seguro Soc.

; 53:268-72.

Naldi L, Parazzini F, Brevi A, Peserico A, Veller Fornasa C,

Grosso G, et al. Family history, smoking habits, alcohol

consumption and risk of psoriasis. Br J Dermatol. 1992;

:212-7.

McAleer MA, Mason DL, Cunningham S, O'Shea SJ, Mc-

Cormick PA, Stone C, et al. Alcohol misuse in patients

with psoriasis: identification and relationship to disease

severity and psychologicaldistress. Br J Dermatol. 2011;

:1256-61.

Kim N, Thrash B, Menter A. Comorbidities in psoriasis

patients. Semin Cutan Med Surg. 2010; 29:10-5.

Bouguéon K, Misery L. Depression and psoriasis. Ann

Dermatol Venereol. 2008; 135 (Suppl 4):S254-8.

Shutty BG, West C, Huang KE, Landis E, Dabade T, Browder

B, et al. Sleep disturbances in psoriasis. Dermatol

Online J. 2013; 19:1.

Sampogna F, Gisondi P, Tabolli S, Abeni D; IDI Multipurpose

Psoriasis Research on Vital Experiences investigators.

Impairment of sexual life in patients with psoriasis.

Dermatology. 2007; 214:144-50.

Cabete J, Torres T, Vilarinho T, Ferreira A, Selores M.

Erectile dysfunction in psoriasis patients. Eur J Dermatol.

; 24:482-6.

Moon HS, Mizara A, McBride SR. Psoriasis and psycho-

-dermatology. Dermatol Ther. 2013; 3:117-30.

Jafferany M, Franca K. Psychodermatology: basics concepts.

Acta Derm Venereol. 2016; 96:35-7.

Published
2017-04-17
How to Cite
Roque Ferreira, B., Santiago, L., Simões, J., Ramos, L., Brites, M. M., Reis, J. P., & Figueiredo, A. (2017). Psoriasis, Psychotropic Drugs and Psychiatric Comorbidities: A Case-Control Study with Inpatients. Journal of the Portuguese Society of Dermatology and Venereology, 75(1), 43-48. https://doi.org/10.29021/spdv.75.1.717
Section
Original Articles