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Survey Results Show Moderate to Severe Psoriasis Increases Anxiety and Depression Levels


Researchers evaluated factors affecting quality of life and what to consider when determining a patient’s psoriasis treatment plan.

A poster presentation at the Maui Derm NP+PA Summer 2023 Conference in Colorado Springs, Colorado, June 21-24, assessed the humanistic burden of psoriasis. “Assessing humanistic burden in patients with moderate to severe psoriasis in the United States,” reported findings that despite the availability of various treatments, evidence shows that psoriasis has a significant negative effect on emotional and mental wellbeing, including depression and anxiety levels.1



Researchers used a non-interventional, cross-sectional survey to collect information from adults in the US with moderate to severe psoriasis. The survey collected demographics, clinical characteristics, and outcomes associated with the humanistic burden through use of the Dermatology Life Quality Index (DLQI), the Work Productivity and Activity Impairment Questionnaire-Psoriasis (WPAI-PSO), and additional questions to assess disease related anxiety and depression.

The study included 882 individuals, 92.8% of whom were currently receiving treatment (mean duration=2.9 [±4.8] years). Participants were grouped based on type of treatment. Approximately half the participants (50.8%) reported their symptoms over the previous week as mild, very mild, or nonexistent, 36.5% as moderate, and 12.7% as severe or very severe.

Across all participants, 76.8% reported experiencing anxiety and 57.4% as experiencing depression over their psoriasis during the 30 days prior to the survey. Individuals in the untreated/non-prescription group reported higher levels of depression (78%) and anxiety (94%) than the other groups.

The topical/phototherapy treatment group and the untreated/non-prescription treatment group had the smallest percentages of participants who reported that their anxiety had decreased since beginning treatment.

Users of apremilast reported less reduction in depression than individuals using tumor necrosis factor inhibitor (TNFi) or ustekinumab (43.6%, 50.4%, 52.1% respectively). Similar results were reported when analyzing anxiety levels. 

Participants treated with ustekinumab had the lowest DLQI (7.6 [±6.9]), indicating better QoL than the apremilast users at 8.1 (±7.2), the TNFi users at 8.8 (7.6±), individuals using topical/phototherapy treatment at 10.3 (±5.7), and individuals left untreated or using non-prescription treatments at 11.3 (±7.3).

Presenteeism and absenteeism were also measured to determine total work productivity impairment and activity impairment. Participants in the topical/phototherapy and exploratory groups and those receiving a TNFi had higher presenteeism and activity impairment scores, indicating lower productivity than those using apremilast or ustekinumab.

Investigators concluded that current treatment or lack thereof plays a significant role in QoL, anxiety, depression, and productivity, and that these factors should be considered when making treatment decisions.


  1. Armstrong A, Seigel L, Jayade S, et al. Assessing humanistic burden in patients with moderate to severe psoriasis in the United States. Poster presented at: Maui Derm NP+PA Summer 2023 Conference; June 21-24, 2023; Colorado Springs, CO.

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