In a letter recently published in the British Journal of Dermatology, researchers highlighted the rate of under-screening that outpatients with atopic dermatitis (AD) and psoriasis receive for mental health.
The study, led by Jonathan Silverberg, MD, PhD, MPH, associate professor of dermatology at the George Washington University School of Medicine and Health Sciences, found that, despite established associations of AD and psoriasis with depression and suicidality, as well as recommendations for increased mental health screening in these higher risk patients and available options for timely screening, clinical practice gaps remain with low rates of depression screening.
“The link between AD and psoriasis and depression is likely multifactorial,” said Silverberg. “That can include chronic systemic inflammation, the effects of chronic debilitating disease, social isolation related to their skin disease, sleep deprivation, chronic itch, and pain.”
Analyzing data from 9,345 AD and 2,085 psoriasis visits, the authors observed low screening rates for depression among patients, even those with severe forms of the diseases. They also found males with AD were less likely to be screened for depression than females; however, there was no gender difference among psoriasis patients. Screening rates were similar for both dermatologists and non-dermatologists in AD cases, but lower in dermatologists when it came to psoriasis.
“For many AD and psoriasis patients, the only doctor they see is a dermatologist for their skin condition,” Silverberg said. “It is therefore imperative that their dermatologist recognize the broader ramifications of their skin disease, such as depression, and treat or refer appropriately.”
Silverberg co-authored the article with Partik Singh, MD, MBA, from the Feinberg School of Medicine at Northwestern University. Data analysis for the study occurred at Northwestern University.
To read the letter, titled “Under-screening of Depression in United States Outpatients with Atopic Dermatitis and Psoriasis,” published in the British Journal of Dermatology.
