Effectiveness of Interdisciplinary vs. Dermatological Care of Moderate-
to-severe Psoriasis: A Pragmatic Randomised Controlled Trial
Jochen Schmitt, Gottfried Wozel, Marlene Garzarolli, Antje Viehweg, Michael Bauer, Karolina Leopold
Psychiatric morbidity is frequent in patients with psoriasis. We compared the effectiveness of dermatological vs. interdisciplinary dermatological and psychiatric care for psoriasis. Adults with moderate-to-severe psoriasis were randomly allocated to dermatological (n=24) or interdisciplinary care (n=23) and treated accordingly. Primary endpoint was the mean change in Dermatology Life Quality Index (DLQI) at 6 months. Data was analysed by intention-to-treat. Mean±SD change in DLQI was 7.5±7.3 and 10.5±9.9 after 6 months of dermatological and interdisciplinary care, respectively (p=0.27). At baseline, 10 patients in the interdisciplinary treatment group (43%) had at least one psychiatric disorder. These patients showed significantly better DLQI response (DLQI change 14.8±9.7) than patients receiving dermatological care only (p=0.03). Ninety percent of psoriasis patients with DLQI scores exceeding psoriasis area and severity index (PASI) scores had comorbid psychiatric disease. Although psychiatric co-treatment is not generally required for patients with moderate-to-severe psoriasis, those patients with higher DLQI scores than PASI scores might benefit from interdisciplinary care.