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Patients' Mental Health Impacts Rating of Psoriasis Severity

WEDNESDAY, March 3, 2021 -- Discordance between patient and physician assessments of psoriasis severity is associated with patient depression and anxiety, according to a study published online March 3 in JAMA Dermatology.

Ewan Carr, Ph.D., from King's College London, and colleagues conducted a cohort study to examine discordance between patient- and physician-reported measures of psoriasis severity and examine the correlation with patient mental health status. Data were included for 502 patients between May 12, 2016, and Nov. 1, 2018, with 1,985 total observations.

Of the patients, 9 and 10 percent, respectively, screened positive for depression and anxiety. The researchers found that in 39 percent of the observations, there was discordance between physician and patient measures of disease severity; in 26 and 13 percent of visits, patients rated their psoriasis as less and more severe, respectively, compared with their physicians. The likelihood of a patient overestimating their psoriasis severity compared with their physician was increased for those who screened positive for depression or anxiety (relative risk ratios, 2.7 and 2.1 for depression and anxiety, respectively). After adjustment for age, ethnicity, sex, and other confounding variables, these findings remained statistically significant.

"The recognition, monitoring, and management of depression and anxiety in psoriasis by multidisciplinary health care teams (preferably encompassing clinical psychology expertise) has the potential to alleviate the substantial mental health burden in psoriasis while aligning clinician and patient perceptions of disease and treatment goals," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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