Anxiety and depression levels in psoriatic patients in Almaty, Kazakhstan

Introduction:
Psoriasis is the most common skin disease in Kazakhstan. Psoriatic patients are at increased risk of anxiety and depression. The psychological stress that triggers psoriasis can affect the treatment response.

Objective:
To determine the prevalence of depression and anxiety in psoriatic patients in Almaty.

Material and methods:
This prospective cross-sectional study was conducted at Kazakh's Scientific Center of Dermatology and Infectious Disease and Almaty Venereology Dispenser from November 2020 to April 2021. We used the PASI scale to assess psoriasis severity and the HADS and Hamilton scales for identification and assessment of depression and anxiety.

Results:
The prevalence of anxiety and depression was 47.4% and 46.5%, respectively. Both anxiety and depression were registered in 39.7% of men and 61.0% and 58.5% of women, respectively. Most patients had moderate pruritus. The pruritus severity was associated with anxiety (p = 0.014) and depression (p = 0.025). Patients with a low level of education were more prone to severe depression (p = 0.002). The types of psoriasis in our patients included psoriasis vulgaris (74.0%), guttate (9.3%), erythrodermic (7.4%), pustular (5.6%), and palmoplantar (3.7%) forms. No statistically significant difference in the prevalence of anxiety (p = 0.623) and depression (p = 0.565) was revealed among patients with different clinical forms of psoriasis.

Conclusions:
Anxiety and depression are common among psoriatic patients, especially in females. The disease severity correlates with the severity of anxiety but not with depression. Comorbidities increase the likelihood of depression. Further studies with control groups or population-based studies are required to determine the impact of psoriasis on mental health.