Neuro-Psychiatric Comorbidity among Psoriatic Adolescents

Abstract

Background

Psoriasis is a known risk factor for neuro-psychiatric diseases among adults. Less is known regarding adolescents.

Objective

Investigating the association between psoriasis and neuro-psychiatric comorbidity and social skills among adolescents.

Methods

A population based cross-sectional study between January 1^st, 1999 and January 1^st, 2014 was conducted. The study included 1746 and 1366 adolescents (aged 16 to 18) with mild and moderate to severe psoriasis, respectively. All psoriasis patients were diagnosed by a dermatologist. Neuro-psychiatric diseases were diagnosed by a neurologist and a psychiatrist, accordingly. Social skills were evaluated by a psychosocial assessment. Psoriasis patients were compared to 884653 healthy control patients by a multivariate analysis adjusted for age, sex, country of origin, socio-economic status, cognitive skills and body mass index. A subgroup evaluation was done for comorbidity which could only be evaluated for part of the recruitment years, by a univariate analysis.

Results

Overall chronic headaches (8.1% vs. 3.4%), intermediate frequency migraine (4.8% vs. 1.6%), low frequency migraine and non-migraine headaches (3.4% vs. 1.8%) were associated only with moderate to severe psoriasis compared to healthy controls [Adjusted odds ratios (adj. ORs) 1.9, 2.3, 1.5; 95% confidence intervals (CIs) 1.6-2.4, 1.8-3.0 and 1.1-2.1, respectively]. Anxiety disorders (2.1% vs. 0.7%) and impaired social adjustment skills (7.5% vs. 4.2%) were also associated only with moderate to severe psoriasis compared to healthy controls (ORs 2.9, 1.9; 95% CIs 1.6-5.5 and 1.3-2.6; Of 466 vs. 265023, respectively).

Conclusion

Psoriasis among adolescents is associated with neuro-psychiatric co-morbidities and impaired adjustment skills, depending on disease severity.

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