title: A Cross-sectional Study of Prevalence and Implications of Depression and Anxiety in Psoriasis.
abstract: BACKGROUND
  Physical and mental comorbidity is common and has significant implications for overall health outcomes. Psoriasis, a psychocutaneous disorder, is a classic example of mental-physical comorbidity.
  
  
  OBJECTIVE
  In view of the impact of socio-cultural influences on mind-body interactions and the paucity of Indian research pertaining to psychiatric morbidity in psoriatic patients, this study was undertaken to measure the prevalence of anxiety and depression in patients with psoriasis, and to correlate these with severity of psoriasis and quality of life.
  
  
  METHODS
  This cross-sectional study was conducted on 90 consecutive patients of psoriasis, over a period of 12 months, in a tertiary care centre. The Psoriasis Area and Severity Index was used to assess severity of psoriasis. PHQ-9, GAD-7 and the Perceived Stress Scale were used to screen for depression, anxiety and perceived stress respectively. The WHOQOL-BREF was used to determine the quality of life.
  
  
  METHODS
  All analysis was performed using Microsoft Excel software and Statistical Package for Social Sciences.
  
  
  RESULTS
  A total of 71 (78.9%) subjects had depression and 69 (76.7%) had anxiety. Fifty one patients had significant stress. A significant positive correlation was established between psoriasis variables (severity and duration of psoriasis) and psychological variables (depression, anxiety and stress). Severity of psoriasis had a significant negative correlation with social relationships and environmental domains of WHOQOL. Quality of life was significantly worse in patients with psoriasis with comorbid anxiety/depression.
  
  
  CONCLUSIONS
  Patients with psoriasis have a clinically significant prevalence of depression, anxiety and perceived stress. This study highlights the complex relationship between psoriasis, psychiatric comorbidity and quality of life and the need to simultaneously consider dermatological and psychological factors.
authors.affiliation: Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
authors.forename: Sreelatha
authors.initials: S
authors.lastname: Lakshmy
authors.affiliation: Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
authors.forename: Sivaprakash
authors.initials: S
authors.lastname: Balasundaram
authors.affiliation: Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
authors.forename: Sukanto
authors.initials: S
authors.lastname: Sarkar
authors.affiliation: Department of Dermatology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
authors.forename: Moutusi
authors.initials: M
authors.lastname: Audhya
authors.affiliation: Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
authors.forename: Eswaran
authors.initials: E
authors.lastname: Subramaniam
keywords: Anxiety; depression; psoriasis; psychodermatology