Higher Prevalence of Depression, ADHD Observed Among Women With Psoriatic Arthritis

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SAN DIEGO — Researchers observed a higher prevalence of psychiatric disorders, including attention-deficit/hyperactivity disorder (ADHD) and depression, among female patients with psoriatic arthritis (PsA) compared with male patients, according to data presented at the 2017 ACR/ARHP Annual Meeting.

Soumya M. Reddy, MD, from the Department of Medicine, Division of Rheumatology at New York University School of Medicine, and colleagues sought to characterize the prevalence and gender-driven differences of psychiatric disorders among patients with PsA at the New York University Psoriatic Arthritis Center. 

The study included 253 adult patients who met classification criteria for PsA (CASPAR). The participants were assessed for presence of anxiety, depression, and ADHD. The researchers collected objective measures of disease severity, including swollen and tender joint counts and the percentage of body surface area covered by psoriasis.Physician global assessment and routine assessment of patient index data 3 (RAPID3) scores were recorded at the time of visit, along with arthritis, skin, and nail global scores.

The results showed that 27.8% of patients with PsA had a psychiatric diagnosis, including depression (18.7%), anxiety (14.7%), and ADHD (4.8%). 

There was a significantly higher prevalence of psychiatric disorders among female patients with PsA compared with male patients (34.5% vs 22.1%; P=.028). Female patients had a higher prevalence of depression (25% vs 13.2%; P=.017) and use of antidepressants (22.2% vs 11.8%; P=.048). In contrast, men had higher use of medications for bipolar disorder (9.1% vs 2.1%; P=.037).

Disease severity was similar between groups, but female patients reported higher RAPID3 scores compared with male patients (12.09 vs 8.95; P=.007). Male patients, but not female patients, with a psychiatric diagnosis had significantly lower swollen joint counts compared with patients without a psychiatric comorbidity (0.79 vs 1.82; P=.14). Furthermore, female patients with a psychiatric diagnosis had lower percentage of body surface area covered by psoriasis.

“Further understanding of these gender-driven differences is needed to evaluate the impact on PsA disease burden, adherence, and management,” the investigators noted.

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Reference

Reddy SM, Haberman R, Lydon E, et al. Prevalence of depression and attention deficit hyperactivity disorder in female patients at a combined psoriasis-psoriatic arthritis center. Presented at: 2017 ACR/ARHP Annual Meeting; November 3-8, 2017; San Diego, CA. Abstract 2528.