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Psoriasis and Mental Health Workshop Report: Exploring the Links between Psychosocial Factors, Psoriasis, Neuroinflammation and Cardiovascular Disease Risk

C. Elise Kleyn, Peter S. Talbot, Nehal N. Mehta, Francesca Sampogna, Chris Bundy, Darren M. Ashcroft, Alexa B. Kimball, Peter C.M. van de Kerkhof, Christopher E.M. Griffiths, Fernando Valenzuela, Joelle M. van der Walt, Tsion Aberra, Lluís Puig
DOI: 10.2340/00015555-3375

Preview of fully accepted paper, still not published in any volume

Abstract

Psoriasis is a systemic, relapsing, inflammatory disease associated with serious comorbidities including mood problems and/or unhealthy lifestyle behaviours. Cutaneous and systemic abnormalities in innate and acquired immunity play a role in its pathogenesis. The exact pathogenetic mechanism remains elusive. Evidence is accumulating that TNF-alpha, IL-17 and IL-23 signalling are highly relevant as targeting these pathways reduces disease activity. Evidence suggests a strong link between psoriasis and depression in adults. The International Psoriasis Council (IPC) held a roundtable event, “Psoriasis and Mental Health”, in Barcelona, Spain which focused on the presence of depression and suicidality, plus the role of neuroinflammation in psoriasis, sleep disruption and the impact of depression on cardiovascular disease outcomes. We summarize here the expert presentations to provide additional insight into the understanding of psychiatric comorbidities of psoriasis and of the impact of chronic, systemic inflammation on neuro- and cardiovascular outcomes. the associations between psoriasis and other psychiatric comorbidities are still controversial and warrant further attention.

Significance

Psoriasis is a chronic, systemic disease which is marked by a significant psychosocial burden. In recent years, multiple lines of evidence support the strong association between psoriasis and psychosocial comorbidities. The role of neuro­inflammation in psoriasis pathology, sleep disruption and the impact of depression on cardiovascular outcomes was explored in a workshop convened by the International Psoriasis Council. The workshop was assembled to increase the understanding of depression as an important comorbidity of psoriasis and elevate awareness of the impact of chronic systemic inflammation on neuro- and cardiovascular outcomes. Studies discussed at this workshop suggest that depression is consistently associated with psoriasis, while suicidal ideation is not. Increased awareness of and concern about effective depression management in patients with psoriasis will undoubtedly improve overall disease management.

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