Psoriasis is a condition with a significant negative socio-economic impact. Even today, with a more effective range of therapies than ever, at least half of those with even mild disease, are not being treated. Since psoriasis is a chronic condition and is undertreated, it is often associated with anxiety and depression, which may translate into addictive behaviours.
In this study from Germany, researchers investigated this question in psoriasis patients attending a University Hospital outpatient department. They used a validated 92-item questionnaire related to the six most common addictions in Germany i.e. alcohol, nicotine, drugs and illegal drugs, gambling and eating behaviours. They also recorded body weight and height and current psoriasis severity, using the Psoriasis Area and Severity Index (PASI) score.
A total of 102 patients (65 males, 37 females) participated with an average age of 49.7 years. Fifty-seven (55.9%) showed addictive behaviours. Of these 23.8% were high-risk drinkers, 41% smokers, 11% at risk of drug abuse, 4.1% at risk of food dependency and 19% compulsive gamblers. When compared with the general population, the results were significantly higher for alcohol abuse, smoking and gambling. Body mass index (BMI) was also significantly higher in psoriatic patients.
Comment
The finding that smoking and heavy alcohol consumption are more common in people with psoriasis, is already well documented, so not at all surprising. The high rate of compulsive gambling most certainly is surprising and – if true – is hard to explain. Perhaps gambling is a form of distraction, and it would be interesting to see whether other chronic diseases show a similar association. In any event, healthcare professionals who manage those with psoriasis, would do well to bear these findings in mind, since any addictive behaviour may have a negative impact on symptoms and long-term outlook.
Reference
Zink A, Hermann M, Fischer T et al. Addiction: an underestimated problem in psoriasis health care. J Eur Acad Dermatol Venereol, 2017; 31: 1308-1315
Source:
Dr David Ashton MD PhD