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The association between the clinical diversity of psoriasis and depressive symptoms: the HUNT Study, Norway.

https://arctichealth.org/en/permalink/ahliterature290075
Source
J Eur Acad Dermatol Venereol. 2017 Dec; 31(12):2062-2068
Publication Type
Journal Article
Date
Dec-2017
Author
E H Modalsli
B O Åsvold
I Snekvik
P R Romundstad
L Naldi
M Saunes
Author Affiliation
Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
Source
J Eur Acad Dermatol Venereol. 2017 Dec; 31(12):2062-2068
Date
Dec-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Depression - etiology
Female
Humans
Male
Middle Aged
Norway
Psoriasis - classification - complications - psychology
Severity of Illness Index
Abstract
While a number of observational hospital-based studies have reported an association between psoriasis and depression, less is known about the clinical diversity of psoriasis and depressive symptoms.
To investigate the associations of inverse psoriasis, psoriasis severity and psoriasis duration with depressive symptoms in a general population.
We linked data from the population-based third Nord-Trøndelag Health Study (HUNT3) to the Norwegian Prescription Database (NorPD) and Statistics Norway. Depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Associations between psoriasis and depressive symptoms (HADS = 8) were estimated using logistic regression.
Among 37 833 participants in HUNT3, we found a weak association between any psoriasis and the prevalence of depressive symptoms [fully adjusted odds ratio (OR) 1.12, 95% confidence interval (CI) 0.97-1.28]. The association with depressive symptoms was stronger when psoriasis was characterized by inverse anatomical distribution (OR 1.32, 95% CI 1.02-1.70), requirement of systemic psoriasis medication (OR 1.47, 95% CI 1.00-2.17) or long disease duration (OR 1.33, 95% CI 1.09-1.64). Conversely, when there was no inverse psoriasis distribution, no requirement of systemic medication, or shorter disease duration, psoriasis was not meaningfully associated with depressive symptoms.
Overall, depressive symptoms do not seem to be a major concern among subjects with psoriasis in a general Norwegian population. However, among subjects with inverse anatomical distribution, requirement of systemic psoriasis medication or long disease duration, depressive symptoms may be particularly important to address when evaluating the burden of psoriasis.
PubMed ID
28662282 View in PubMed
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Psoriasis, fracture risk and bone mineral density: the HUNT Study, Norway.

https://arctichealth.org/en/permalink/ahliterature290897
Source
Br J Dermatol. 2017 May; 176(5):1162-1169
Publication Type
Journal Article
Observational Study
Date
May-2017
Author
E H Modalsli
B O Åsvold
P R Romundstad
A Langhammer
M Hoff
S Forsmo
L Naldi
M Saunes
Author Affiliation
Department of Public Health and General Practice, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
Source
Br J Dermatol. 2017 May; 176(5):1162-1169
Date
May-2017
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Adult
Age Distribution
Aged
Bone Density - physiology
Cross-Sectional Studies
Female
Femur Neck - physiology
Forearm
Hip Fractures - epidemiology - etiology
Humans
Lumbar Vertebrae - physiology
Male
Middle Aged
Norway - epidemiology
Osteoporotic Fractures - epidemiology - etiology
Prospective Studies
Psoriasis - complications - epidemiology - physiopathology
Risk factors
Young Adult
Abstract
An association between psoriasis and osteoporosis has been reported.
To investigate, in a large prospective population-based Norwegian study, whether psoriasis is associated with increased risk of forearm or hip fracture; to investigate the cross-sectional association between psoriasis and bone mineral density (BMD) T-score in a subpopulation.
Hospital-derived fracture data from Nord-Trøndelag County (1995-2013) were linked to psoriasis information, BMD measurements and lifestyle factors from the third survey of the Nord-Trøndelag Health Study 2006-08 (HUNT3); socioeconomic data from the National Education Database; and use of medication from the Norwegian Prescription Database.
Among 48 194 participants in HUNT3, we found no increased risk of forearm or hip fracture in 2804 patients with self-reported psoriasis [overall age- and sex-adjusted hazard ratio 1·03, 95% confidence interval (CI) 0·82-1·31]. No clear association was found between psoriasis and mean BMD T-score; overall age- and sex-adjusted differences in total hip, femoral neck and lumbar spine BMD T-scores were 0·02 (95% CI -0·11 to 0·14), 0·05 (95% CI -0·06 to 0·17) and 0·07 (95% CI -0·09 to 0·24), respectively. No clear association was found between psoriasis and prevalent osteoporosis in either total hip, femoral neck or lumbar spine; overall age- and sex-adjusted odds ratio was 0·77 (95% CI 0·54-1·10). Associations did not change substantially after adjustment for education, smoking, systemic steroid use and body mass index.
We found no association between psoriasis and risk of fracture. The study did not indicate reduced BMD T-score or higher prevalence of osteoporosis among patients with psoriasis.
Notes
CommentIn: Br J Dermatol. 2017 May;176(5):1117-1118 PMID 28504373
PubMed ID
27718508 View in PubMed
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