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. 2022 Jun 10;13:880201. doi: 10.3389/fimmu.2022.880201

Table 3.

Summary of systematic review and meta-analyses assessing the association between psoriasis and mental health diseases.

Study Study dates Total number of patients Number of studies included Outcomes Composite measure of association (95% CI)
Psoriasis No psoriasis
Fleming et al. (88) 2017 2001-2015 938,194 participants 15 studies including 8 cross-sectional studies, 4 cohort studies, and 2 randomized control trials control studies, and 1 case–control study Anxiety risk HR=1.29-1.31, P = 0.001,
OR=2.91, 95% CI, 2.01-4.21
Singh et al. (89) 2017 1946-2017 330,207 1,437,376 18 Suicides risk

  1. Suicidal ideation

    a pooled OR=2.05 (1.54-2.74)

  2. Suicidal behaviors

    a pooled OR=1.26 (1.13-1.40)
Pompili et al. (90) 2021 Databases inception to February 2020 624,593  12,252 21 Suicides risk

  1. Suicidal ideation

    OR = 1.97 (1.26-3.08)

  2. Suicidal acts

    OR = 1.42(1.05-1.92)
Chi et al. (91) 2017 Databases inception to 24 March 2017 381,431 1,072,178 5 Suicides risk

  1.  Suicide

    RR=1.13 (0.87-1.46),

    (1) Suicide attempt

    RR=1.25(0.89-1.75),

    (2) Suicidality

    RR=1.26 (0.97-1.64)
Charoenngam et al. (92) 2021 From inception to 12 July 2019 740,454 from 5 studies 10,013,063 from 5 studies 6 cohort studies Dementia risk Pooled RR=1.16 (1.04–1.30)
Yen et al. (93) 2021 Up to 12 July 2019 10 studies included a total of 16,574 psoriasis cases;
1 study evaluated 7,118 patients with dementia		 10 studies included 45,078 controls;
1 study included 21,354 controls.		 11

  • 1. Risk of dementia or cognitive impairment

  • 2. Psoriasis risk

 9 of the 11 included studies found a significant positive association between the two diseases, one study a null association, and one study an inverse association.
Snast et al. (94) 2018 1964-2015 32,537 patients NR 39 studies including 19 surveys, 7 cross-sectional studies, 12 case–control studies and 1 cohort study.
5 study for meta-analysis

  1. Psoriasis risk

  2. Stress disorder risk

  3. Evaluating stressful events prior to psoriasis exacerbation

  4. Association between stress levels and exacerbation of psoriasis

  1. Onset of psoriasis

    a pooling OR=34, 95% CI:18–64;

  2. Stress disorder risk

    OR=12, 95% CI: 08–18.

  3. Association between stress levels and exacerbation of psoriasis

    r = 028, P < 005

  4. More frequent/severe preceding events among patients with psoriasis.
Stewart et al. (95) 2018 January 1987–December 2016 19,617 in total 12 studies including 2 epidemiological cross-sectional, 3 cohort, and 7 case-control studies; Due to heterogeneity of
data,
a meta-analysis could not be conducted

  1. Onset and/or recurrence of psoriasis.

  2. Association between severity of psychological stress and severity of psoriasis.

 A probable temporal association between different measures of psychological stress and onset, recurrence, and severity of psoriasis.
Gupta et al. (96) 2016 Finalized on 13 January 2015 54,827 NR 33 Formal sleep disorders risk:
OSA;
restless legs syndrome;
insomnia (chronic insomnia and transient insomnia)

  1. Prevalence of OSA is 36%-81.8% in psoriasis versus 2%-4% in the general population.

  2. increase risk of restless legs syndrome prevalence of 15.1%-18% in psoriasis versus 5%-10% in European and North American samples.

  3. The prevalence of insomnia is 5.9%-44.8% in psoriasis vs. 10% prevalence of chronic insomnia and 30-35% prevalence of transient insomnia in general population (P>0.05)

OSA, obstructive sleep apnea; OR, odds ratio; CI, confidence interval; NR, not reported.