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Cross-sectional study data published in The Journal of Rheumatology suggest a significant association between psoriatic arthritis (PsA) and hearing impairment.
Investigators abstracted data from the United States National Health and Nutrition Examination Survey, an ongoing series of cross-sectional surveys of the civilian American population. The present study included data on participants from the 2003 through 2006 and 2009 through 2010 waves who had completed the medical history questionnaire and provided responses to self-reported hearing function, psoriasis, arthritis, and psychiatric comorbidity questions. Multivariable generalized linear and ordinal logistic regression models were used to examine the association of PsA with hearing impairment and psychiatric outcomes.
Overall, data for 10,747 adults age ≥20 years were included in analyses. Participants were more likely to be women, non-Hispanic white, older, and college graduates (all P <.001). The prevalence of PsA and psoriasis without arthritis in the study cohort were 1.1% and 1.6%, respectively. Individuals with PsA were more likely to report hearing difficulties (odds ratio [OR], 1.50; 95% CI, 1.01-2.21; P =.043), to seek mental healthcare services (OR, 1.62; 95% CI, 0.94-2.79; P =.084), and to have depression (OR, 2.01; 95% CI, 1.15-3.52; P =.015) compared with those without PsA. Patients with PsA experienced an average of 1.62 more days of poor mental health over the previous month (P =.033) compared with controls. Analyses using structural equation models showed that hearing impairment mediated 6.5%, 8.3%, and 5.0% of the effect of PsA on depression, days of poor mental health, and seeing a mental healthcare provider, respectively.
PsA was independently associated with a significantly increased risk of hearing impairment, which in turn mediated an association with poorer psychiatric outcomes. These results may assist clinicians in assessing psychiatric risks among patients with PsA and hearing loss.
Reference
Semenov YR, Hsiang EY, Huang A, et al. Association between psoriasis with arthritis and hearing impairment in US adults: data from the National Health and Nutrition Examination Survey [published online January 15, 2019]. J Rheumatol. doi: 10.3899/jrheum.171228
