Psychological Comorbidities in Palmoplantar Psoriasis and Psoriatic Arthritis: A Systematic Review
Bibliographic record
Abstract
Psoriasis, a chronic inflammatory skin disorder, is often accompanied by psychological comorbidities. While the psychological effects of plaque psoriasis are well-documented, other psoriasis subtypes, such as guttate, erythrodermic, pustular, and palmoplantar psoriasis (PPP), remain less studied. This review aimed to examine psychological comorbidities in less-studied psoriasis variants. However, the available literature was limited to PPP and psoriatic arthritis (PsA). A comprehensive search of Medline, Embase, PsycINFO, and PubMed was conducted up to February 2025. Data were extracted on psychological comorbidities, disease severity, and patient demographics in patients with PPP and/or PsA. Seventeen studies (76,567 patients) were included. Depression prevalence in PsA ranged from 7.1% to 41%. In PPP, depression prevalence ranged from 5.7% in Japan to 17.1% in the United States. Anxiety prevalence ranged from 5.1% to 61.4%. Both depression and anxiety were more severe in patients with higher disease activity, with depressed patients being over 4 times more likely to report higher disease severity (AOR: 4.43, P = .001). Additional psychological comorbidities included sleep disturbances (38%) and mood disorders in PPP patients (19.6%). Functional impairment ranged from mild to moderate, with moderate but variable discomfort reported in pain assessments. Current evidence on psychological comorbidities in non-plaque psoriasis is limited to PsA and PPP. PsA and PPP can potentially be associated with an elevated risk for psychological comorbidities, particularly depression, anxiety. These findings highlight the need for comprehensive mental health screening and management in these patient populations. Further research is needed to characterize the psychological burden in other non-plaque psoriasis subtypes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.005 |
| Bibliometrics | 0.008 | 0.010 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".