Analysis of the Prevalence of Mental Disorders in Psoriasis: The Relevance of Psychiatric Assessment in Dermatology.

BACKGROUND: The boundary between Dermatology and Psychiatry has increasing recognition. Psoriasis is a common psychophysiological skin disease with a major impact on patient's quality of life and a paradigmatic example of a pathology in that boundary. Studies are needed to exactly point out the prevalence of specific psychopathology and mental disorders associated with psoriasis. This work intends to analyse the prevalence of psychopathology and psychiatric comorbidities in patients with psoriasis.

METHODS: A systematic review of the literature was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the "5S" model proposed by Haynes. From all the papers retrieved by this search, a total of 34 papers met the inclusion criteria and were then deeply analysed.

RESULTS: The most prevalent mental disorders in these patients are sleep disorders (average prevalence: 62.0%), sexual dysfunction (45.6%), personality (35.0%), anxiety (30.4%), adjustment (29.0%), depressive (27.6%) and substance-related and addictive disorders (24.8%). Other mental disorders have been less described, namely somatic symptoms and related disorders, schizophrenia and other psychoses, bipolar disorder and eating disorders.

CONCLUSIONS: This updated research shows that the prevalence of psychiatric conditions in psoriasis may range from 24% to 90%. The study of the mind-skin connection in psoriasis may improve the knowledge about psoriasis and its psychiatric comorbidities. The link between psoriasis and associated mental disorders is frequently forgotten or not considered in the clinical practice. Psychiatric disorders in patients with psoriasis may be underdiagnosed. These patients would really benefit from psychiatric assessment, with therapeutic relevance.