Psoriatic Arthritis and Depression

If you have psoriasis or psoriatic arthritis (PsA), your doctor is probably focused on controlling your physical symptoms and preventing them from worsening. While caring for your skin and joints is obviously crucial, a recent study suggests that many patients could use help managing their mental health, too.

The study, published in the journal Arthritis Care & Research, was an analysis of 56 earlier studies and included data on 1,147 patients with psoriasis and 337 with PsA, an inflammatory joint disease that occurs in some people with psoriasis. The authors found that psoriasis and PsA patients often report struggling in many psychosocial areas.

Patients commonly said they were:

  • Anxious about the unpredictability of their symptoms
  • Ashamed and embarrassed about their appearance and felt isolated by it
  • Stressed and overwhelmed about their ability to function in daily life
  • Disappointed in how they responded to treatment.

Some quotes from patients included:

  • “I can’t control it; it controls me.”
  • “The worry is always there that this is going to get worse and worse.”
  • “You feel ostracized as if you were a monster. The only thing missing is pitchforks and torches.”
  • “When I come home [from work], I mostly sleep. I don’t have enough energy to be social.”

These findings have implications for how psoriasis and PsA patients should be treated, the authors wrote. “Health services must be able to provide timely and appropriate mental health referral for patients when illness is discovered.”

“As health care providers… we need to have open discussions and set realistic goals for each patient individually,” Carrie Beach, BSN, RN-BC, the nursing education coordinator at Columbus Arthritis Center, wrote on Healio. She noted that it can be frustrating for patients to see ads or pamphlets that suggest they can totally get rid of their pain and have perfectly clear skin, which may not be possible. “Addressing these concerns with honesty and compassion, assessing each individual’s psychosocial needs and building trusting patient/provider relationships, will hopefully lead to improved adherence and outcomes for these patients.”

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