Priority 16 from the Psoriasis PSP

UNCERTAINTY: How does psoriasis affect a person psychologically? (JLA PSP Priority 16)
Overall ranking 16
JLA question ID 0072/16
Explanatory note Not available for this PSP

Abbott, 2015 Evidence that TNF-α inhibitor therapy reduces depression in people who have chronic diseases (including those with psoriasis) though the effects are small.    Limited data available.  Further studies investigating a more detailed timeline of changes in depression, inflammatory biomarkers and disease activity status in patients with psoriasis (and other chronic diseases) are required. 

Cullen, 2019 Evidence for a positive overall association between non-neurological autoimmune (NNAI) disorders and psychosis, which was not consistent across all NNAI disorders.  Separate meta-analyses were conducted for individual autoimmune disorders.  A significant positive association was observed for psoriasis.  Future work recommended: 1) studies should be designed to better disentangle the temporal nature of the association between NNAI disorders and psychosis, as such studies have demonstrated that both psychosis and depression show bidirectional associations with autoimmune disorders; 2) larger studies should be undertaken to examine the presence of neuronal surface autoantibodies among individuals with psychosis; 3) greater efforts should be made in large cohort studies to include information on potential confounders, such as socioeconomic status, adversity, and tobacco use; and 4) studies should be undertaken to evaluate the effect of corticosteroid treatment on the relationship between NNAI disorders and psychosis.

Chi, 2017 This systemic review and meta-analysis concluded that the available limited, very low-quality evidence does not support an association between psoriasis and suicidal thought and behaviour.  Further studies that provide data for different age and sex groups are needed to clarify whether a subgroup of patients with psoriasis has an elevated risk of suicidality. 

Chen 2014 Evidence that psychological and/or educational interventions improve psychological and quality of life (QOL) outcomes in psoriasis.  The review concluded that further research is needed to examine the effectiveness of psychological and/or educational interventions for individuals with psoriasis, including a greater number of RCTs in order to increase the methodological validity of intervention studies.  Also, future research needs to be conducted to establish which interventions are most effective for specific sub-populations who may best profit from psycho-educational interventions.

See data sheet for list of evidence considered.

Health Research Classification System category Skin
Extra information provided by this PSP
Original uncertainty examples Does living with psoriasis make you more likely to want to commit suicide?
Submitted by 8 uncertainties were submitted around this question
PSP information
PSP unique ID 0072
PSP name Psoriasis
Total number of uncertainties identified by this PSP. 55  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 17 September 2018