Depressive, anxiety, stress, and insomnia symptoms in patients with psoriasis: a cross-sectional study

Introduction
Assessment of psychological well-being in psoriasis patients is recommended. However, studies evaluating depressive, anxiety, stress, and insomnia symptoms in Arabic patients with psoriasis are lacking.

Aim
To quantify levels of psoriasis-related depressive, anxiety, stress, and insomnia symptoms in Arabic patients with psoriasis.

Material and methods
A cross-sectional survey on patients’ demographics, disease characteristics, and psychological measures using the Patient Health Questionnaire-9, Generalized Anxiety Disorder 7-item scale, Depression Anxiety Stress Scale-21 (7-item stress subscale), and Insomnia Severity Index. The prevalence and scores of depressive, anxiety, stress, and insomnia symptoms were calculated. Multivariate linear regression models were developed to assess patients’ demographics and disease characteristics affecting the psychological measures.

Results
The analysis included 223 patients. The patients reported mild levels of depressive, anxiety, and insomnia symptoms (median (interquartile range (IQR)) scores: 9 (6–14), 6 (4–11), and 12 (4–18), respectively) and a moderate level of stress symptoms (median (IQR) score: 10 (5–14)). The prevalence of depressive, anxiety, stress, and insomnia symptoms were 47.1%, 32.7%, 59.6%, and 57%, respectively. Multivariate linear regression analyses revealed that for each unit increase in the impact of psoriasis on daily life, there were 5.7 (95% confidence intervals (CI): 3.7–7.8), 3.8 (95% CI: 1.8–5.7), 5.3 (95% CI: 3.1–7.4), and 6.5 (95% CI: 3.7–9.4) units in increase in depression, anxiety, and stress, and insomnia scores, respectively, or sa-SPI-p score > 7.

Conclusions
The prevalence of depressive, anxiety, stress, and insomnia symptoms in Arabic patients with psoriasis was high. Clinical interventions, screening for psychiatric comorbidities, and consideration of psychotherapy should be implemented in this patient group.