Shrikant B. Deshmukh1, Parth S. Deshmukh2, Ashish V. Saboo3, G. R. Mundhada4

BACKGROUND: Psoriasis is relatively common, chronic inflammatory and hyper-proliferative skin disease that affects 1.4% to 2.0% of the population. Presence of itching, chronic recurrent course of disease and incomplete cure may contribute to great deal of psychiatric co-morbidity in these patients. the most persuasive indications of a link between stress and psoriasis comes from patients themselves, with studies illustrating that the majority of patients believe that stress or psychological distress is a factor in the manifestations of their condition . Depression and anxiety are the most common disorders that are associated with psoriasis, but the proportion of patient also having other psychiatric co-morbid diseases which include social phobia, generalize anxiety disorder, panic disorder, psychotic disorder, etc. Moreover, symptoms of psoriasis, especially pruritus, are related to depression.

OBJECTIVES: To evaluate different psychiatric illnesses their prevalence and severity in psoriasis patients.

METHODOLOGY: This was cross-sectional observational study comprised of 70 consecutive patients of psoriasis attending the out-patient department of Dermatology. All the patients were subjected to detailed examinations including the elicitation of dermatological and psychiatric profile after getting written consent for study. Data was collected using self-developed, pre tested, semi structured Pro format by interview method.

RESULTS: The profile of psychiatric diagnoses obtained in the present study depressive disorder 31.4% {18.57% depression, 12.85% Depression with anxiety symptoms}, anxiety disorder 25.7% (7.14% GAD, 8.17% panic disorder, 5.71% social phobia, 4.28 specific phobia). Severity of major depressive disorder was determined with HAM-D score 53.8% had mild depression, 30.7% moderate depression and 15.5% severe depression. Similarly when HAM-A scale was used to determined severity of generalized anxiety disorder in psoriasis patients then 40% had mild anxiety 40% had moderate anxiety and 20% had severe anxiety.

CONCLUSION: Psoriasis is associated with high level of psychiatric co-morbidity. Depression and anxiety disorders were most frequent disorders present co-morbidly in patients of psoriasis. There was no co-relation between severity of psoriasis and psychiatric illness.