Low Prevalence but Meaningful Impact of Psychological Symptoms Seen in Well-Controlled Psoriasis
Anxiety and depression symptoms can still occur in young adults with well-controlled psoriasis, even when disease activity is minimal, according to a cross-sectional study exploring psychological distress and its potential biological correlates. Although prevalence was low, the findings suggest that mental health screening may remain relevant in this population.
The study evaluated 80 adults with psoriasis (mean age, 38.7 years) who were considered well treated and expected to have little psychological burden. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, while exploratory analyses examined associations with inflammatory cytokines and metabolic markers using regression and random forest models.
Anxiety symptoms were identified in 6% of patients, and depression symptoms in 12%. Those affected had clinically significant anxiety scores and borderline depression symptoms, despite otherwise well-controlled skin disease. The authors noted that “anxiety and depressive symptoms can occur in well-treated young psoriasis patients,” underscoring that disease control does not eliminate psychosocial risk.
No statistically significant associations were observed between anxiety or depression scores and inflammatory or metabolic markers. However, exploratory machine-learning analyses suggested that certain variables, including IL-6, IL-23, FIB-4, HOMA-IR, and waist circumference, may contribute to variance in depression symptoms. The investigators emphasized that these findings are preliminary, stating that associations with inflammatory and metabolic markers “should be considered hypothesis-generating and warrant validation in larger, independent cohorts.”
Importantly, no clear biological contributors emerged for anxiety symptoms, reinforcing the multifactorial nature of psychological distress in psoriasis. The low overall prevalence of symptoms may reflect effective disease management, but the presence of clinically relevant distress in a subset of patients highlights ongoing unmet needs.
For dermatologists, the key takeaway is that psychological symptoms may persist even in young patients with well-controlled psoriasis and low objective disease burden. While routine screening for all patients may not be necessary, targeted assessment—particularly when patients report subtle distress or functional concerns—may help identify those who would benefit from additional support. The study reinforces the importance of viewing psoriasis care through a biopsychosocial lens, even when treatment goals appear to be met.
Reference
Merzel Šabović EK, Kraner Šumenjak T, Janić M. Psychological distress in young adults with well-controlled psoriasis. Front Psychiatry. 2026;16:1753103. doi:10.3389/fpsyt.2025.1753103
