Survey: Depression Worsened Psoriasis Symptoms, QOL During COVID-19 Lockdown

Self-reported data from patients with psoriasis have revealed factors associated with worsened symptoms and quality of life (QoL) amid the COVID-19 lockdown.

Findings from the survey, completed by nearly 300 patients in their early 30s in Lithuania, suggest that certain symptoms of depression could help identify patients vulnerable to both worsening psoriasis symptoms and disease-related quality of life (QoL).

“During the COVID-19 lockdowns, a considerable number of subjects with somatic illnesses may have found it more difficult to access health care services and receive their usual treatment, leading to deterioration of clinical symptoms,” detailed the researchers. “Overall, the COVID-19 pandemic lockdown has affected many people with somatic conditions, as well as patients’ psychological wellbeing and quality of life (QoL); individuals with psoriasis were no exception.”

More than half of patients reported having worsening symptoms throughout the lockdown period in 2021, though the researchers noted that data was subjectively collected rather than through objective clinic documentation. The strongest predictor of worsening psoriasis symptoms was a need for changing psoriasis treatment during lockdown, which was associated with an odds ratio (OR) of 2.73 (95% CI, 1.37– 5.44; P = .004). Experiencing a decrease in income also doubled the probability of worsening symptoms (OR = 2.33; 95% CI, 1.30–4.17; P = .004).

Having symptoms of depression, which was present in 43% of patients, impacted severity of symptoms with an OR of 1.10 (95% CI, 1.05–1.14; P < .001). Similarly, QoL was also affected by depression (OR = 1.07; 95% CI 1.02–1.16; P = .008), though the specific symptoms of depression varied between worsening symptoms and QoL. While thoughts of feeling down, depressed, or hopeless were associated with worsening symptoms, suicidal thoughts were associated with impaired QoL.

Having worsening psoriasis symptoms led to impairments in disease-related QoL, which was reported by nearly 1 in 4 (23.6%) patients. The probability of impaired QoL tripled for respondents with worsening symptoms during the lockdown (OR = 3.22; 95% CI, 1.66–6.24; P < .001). Males also faced a significantly higher OR of impaired QoL, with an OR of 3.35 (95% CI, 1.70–6.59; P < .001) compared with females.

“Hopefully, taking our research into consideration, several health and research practices could be implemented. In our study were able to identify specific modifiable and non-modifiable factors related with both psoriasis symptom worsening and impaired QoL in individuals with psoriasis during COVID-19 pandemic,” explained the researchers. “Along with other well-known risk factors (such as alcohol use, smoking, anxiety and alexithymia), the factors we identified could be used for targeted prevention and intervention.”

Reference

Burkauskas J, Slabadiene M, Podlipskyte A, Steibliene V. Factors associated with worsened clinical symptoms of psoriasis and disease-related quality of life during the COVID-19 lockdown: a cross-sectional study. Front Med. Published online January 10, 2023. doi:10.3389/fmed.2022.1027853