medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2024-9-46-50medalphabet-3775Research ArticleСтатьиОсобенности течения заболевания, качества жизни и цитокинового профиля у пациентов с вульгарным псориазом в стационарной стадии и коморбидной депрессиейFeatures of the course of the disease, quality of life and cytokine profile in patients with psoriasis vulgaris in the stationary stage and comorbid depressionГорловаН. А.GorlovaN. A.

Горлова Нина Александровна - ассистент, кафедра дерматовенерологии и косметологии.

Симферополь

Nina A. Gorlova – assistant, Dept of Dermatovenereology and Cosmetology.

Simferopol

heymakaronka@gmail.comШеренговскаяЮ. В.SherengovskayaYu. V.

Шеренговская Юлия Владимировна - ассистент, кафедра дерматовенерологии и косметологии.

Симферополь

Yulia V. Sherengovskaya - assistant, Dept of Dermatovenereology and Cosmetology.

Simferopol

tkachenko.julia@bk.ruРавлюкД. А.RavlyukD. A.

Равлюк Дарья Александровна - к.м.н., доцент, кафедра дерматовенерологии и косметологии.

Симферополь

Daria A. Ravlyuk - PhD Med., associate professor, Dept of Dermatovenereology and Cosmetology.

Simferopol

darya-ravluk@mail.ruПрохоровД. В.ProkhorovD. V.

Прохоров Дмитрий Валерьевич - д.м.н., профессор, кафедра дерматовенерологии и косметологии.

Симферополь

Dmitry V. Prokhorov - DM Sci (habil.), professor, Dept of Dermatovenereology and Cosmetology.

Simferopol

dvpro2022@mail.ruИспирьянМ. Б.IspiryanM. B.

Испирьян Михаил Борисович - к.м.н., доцент, кафедра дерматовенерологии и косметологии.

Симферополь

Mikhail B. Ispiryan - PhD Med., associate professor, Dept of Dermatovenereology and Cosmetology.

Simferopol

salekisa1975@gmail.comОрдена Трудового Красного Знамени Медицинский институт имени С.И. Георгиевского (структурное подразделение ФГАОУ ВО Крымского федерального университета имени В.И. Вернадского)РоссияOrder of the Red Banner of Labor of the Medical Institute named after S.I. Georgievsky (structural unit V.I. Vernadsky Crimean Federal University)Russian Federation20242007202409Дерматология (1)4650Copyright © Горлова Н.А., Шеренговская Ю.В., Равлюк Д.А., Прохоров Д.В., Испирьян М.Б., 20242024Горлова Н.А., Шеренговская Ю.В., Равлюк Д.А., Прохоров Д.В., Испирьян М.Б.Gorlova N.A., Sherengovskaya Y.V., Ravlyuk D.A., Prokhorov D.V., Ispiryan M.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/3775Цель

Цель. изучение особенностей течения заболевания, качества жизни и цитокинового профиля у пациентов с вульгарным псориазом в стационарной стадии и депрессией.

Материал и методы

Материал и методы. В проспективном одномоментном сравнительном исследовании приняли участие 154 пациента с вульгарным псориазом в стационарной стадии; из них были сформированы две группы: 83 пациента с коморбидной депрессией и 71 – без коморбидной депрессии. Для определения симптомов депрессии и ее тяжести использовали шкалу Гамильтона.

Результаты

Результаты. Пациенты с вульгарным псориазом в стационарной стадии и депрессией характеризовались более молодым возрастом (р=0,007), более тяжелым течением заболевания по индексу PASI (р<0,001), визуально-аналоговой шкале (р=0,014), более высокой частотой рецидивов (р=0,012) и более низким уровнем качества жизни по опроснику DLQI (р<0,001), а также более высокими значениями IL-6 и IL-17 в сыворотке крови (р=0,011; р=0,001 соответственно). Установлен обратный характер корреляционной связи между средним суммарным значением по шкале Гамильтона и возрастом пациентов (r= –0,61; р=0,002), прямой – средними суммарными значениями по индексу PASI (r=0,72; р=0,001), визуально-аналоговой шкале (r=0,63; р<0,001), DLQI (r=0,69; р=0,001) и IL-17 (r=0,62; р=0,012).

Заключение

Заключение. У пациентов с депрессией вульгарный псориаз в стационарной стадии протекает тяжелее, сопровождается нарастанием системных провоспалительных сдвигов и более существенным снижением качества жизни, чем у пациентов без депрессии. Полученные результаты необходимо учитывать при выборе стратегии терапевтического воздействия на вульгарный псориаз, что позволит персонифицировать лечение и повысить его эффективность.

Aim

Aim. To study the characteristics of the course of the disease, quality of life and cytokine profile in patients with psoriasis vulgaris in the stationary stage and depression.

Material and methods

Material and methods. A prospective, cross-sectional comparative study involved 154 patients with vulgar psoriasis in the stationary stage; Of these, two groups were formed: 83 patients with comorbid depression and 71 without comorbid depression. The Hamilton scale was used to determine depressive symptoms and severity.

Result

Result. Patients with psoriasis vulgaris in the stationary stage and depression were characterized by a younger age (p=0.007), a more severe course of the disease according to the PASI index (p<0.001), visual analogue scale (p=0.014), and a higher frequency of relapses (p=0.012) and a lower level of quality of life according to the DLQI questionnaire (p<0.001), as well as higher values of IL-6 and IL-17 in the blood serum (p=0.011; p=0.001, respectively). An inverse correlation was established between the average total value on the Hamilton scale and the age of the patients (r= –0.61; p=0.002), a direct one – with the average total values on the PASI index (r=0.72; p=0.001), visually analogue scale (r=0.63; p<0.001), DLQI (r=0.69; p=0.001) and IL-17 (r=0.62; p=0.012).

Conclusion

Conclusion. In patients with depression, psoriasis vulgaris in the stationary stage is more severe, accompanied by an increase in systemic proinflammatory changes and a more significant decrease in quality of life than in patients without depression. The results obtained must be taken into account when choosing a therapeutic strategy for psoriasis vulgaris, which will personalize treatment and increase its effectiveness.

вульгарный псориаздепрессиякачество жизницитокиновый профильpsoriasis vulgarisdepressionquality of lifecytokine profileReferencesКруглова Л. С., Бакулев А. Л., Коротаева Т. В., Лила А. М., Переверзева Н. О. Псориаз. ГЭОТАР-Медиа. 2022.– 328 с.Kruglova L.S., Bakulev A.L., Korotaeva T.V., Lila A.M., Pereverzeva N.O. Psoriasis. GEOTAR-Media. 2022.– 328 p. (In Russ.).Sahi FM, Masood A, Danawar NA, et al. Association Between Psoriasis and Depression: A Traditional Review. Cureus. 2020;12(8): e9708. https://doi.org/10.1016/j.10.7759/cureus.9708Sahi FM, Masood A, Danawar NA, et al. Association Between Psoriasis and Depression: A Traditional Review. Cureus. 2020;12(8): e9708. https://doi.org/10.1016/j.10.7759/cureus.9708Самушия М. А., Рожкова Ю. И., Затейщиков Д. А., Круглова Л. С., Лобанова В. М. Соматореактивная циклотимия. Вопросы конкурирующих за роль осциллятора ритма аффективной патологии соматических заболеваний: псориаз и легочная артериальная гипертензия (клинический случай). Психиатрические расстройства в общей медицине. 2018.– N 4.– C. 21–26.Samushiya M. A., Rozhkova Yu.I., Zateyshchikov D. A., Kruglova L. S., Lobanova V. M. Somatoreactive cyclothymia. Issues of somatic diseases competing for the role of rhythm oscillator of affective pathology: psoriasis and pulmonary arterial hypertension (clinical case). Psychiatric disorders in general medicine. 2018.– N 4.– pp. 21–26 (In Russ.).Владимирова И. С., Круглова Л. С., Свиридов О. В., Самушия М. А. Эффективность терапии больных псориазом с тревожностью и депрессией ингибитором интерлейкина-23 гуселькумабом. Медицинский алфавит. 2023 (24): 28–35.Vladimirova I. S., Kruglova L. S., Sviridov O. V., Samushiya M. A. Efficacy of treatment of patients with psoriasis with anxiety and depression with the interleukin-23 inhibitor guselkumab. Medical alphabet. 2023 (24): 28–35 (In Russ.).Mathur A., Neema S., Sahu R., Radhakrishnan S. Anxiety, depression and harmful use of alcohol in severe chronic plaque psoriasis: A cross-sectional study. Med J Armed Forces India. 2023; 79 (4): 464–469. https://doi.org/10.1016/j.mjafi.2020.10.014.Mathur A., Neema S., Sahu R., Radhakrishnan S. Anxiety, depression and harmful use of alcohol in severe chronic plaque psoriasis: A cross-sectional study. Med J Armed Forces India. 2023; 79 (4): 464–469. https://doi.org/10.1016/j.mjafi.2020.10.014.Якубович А. И., Новицкая Н. Н., Баранчук Н. И. Психосоматические аспекты патогенеза псориаза. Сибирский медицинский журнал. (Иркутск). 2013; 118 (3): 5.Yakubovich A. I., Novitskaya N. N., Baranchuk N. I. Psychosomatic aspects of the pathogenesis of psoriasis. Siberian Medical Journal. (Irkutsk). 2013; 118 (3): 5 (In Russ.).Schmieder A., Schaarschmidt M.-L., Umar N., et al. Comorbidities signi cantly impact patients’ preferences for psoriasis treatments. J Am Acad Dermatol. 2012;67(3):363–372. https://doi.org/10.1016/j.jaad.2011.08.023.Schmieder A., Schaarschmidt M.-L., Umar N., et al. Comorbidities signi cantly impact patients’ preferences for psoriasis treatments. J Am Acad Dermatol. 2012;67(3):363–372. https://doi.org/10.1016/j.jaad.2011.08.023.Sriramoju S., Dunde S., Eggadi V. et al. Evaluation of Depression and Quality of Life in Patients With Psoriasis. International Journal of Dermatology and Venereology. 2022;5(1):27–31. https://doi.org/10.1097/JD9.0000000000000180Sriramoju S., Dunde S., Eggadi V. et al. Evaluation of Depression and Quality of Life in Patients With Psoriasis. International Journal of Dermatology and Venereology. 2022;5(1):27–31. https://doi.org/10.1097/JD9.0000000000000180Бурчаков Д. И., Успенская Ю. Б. Антиоксидантный, противовоспалительный и седативный эффекты мелатонина: результаты клинических исследований. Журнал неврологии и психиатрии им. С. С. Корсакова. Спецвыпуски. 2017; 117 (4–2): 67–73. https://doi.org/10.17116/jnevro20171174267–73Burchakov D. I., Uspenskaya Yu. B. Antioxidant, anti-inflammatory and sedative effects of melatonin: results of clinical studies. Journal of Neurology and Psychiatry. S. S. Korsakov. Special issues. 2017; 117 (4–2): 67–73 (In Russ.). https://doi.org/10.17116/jnevro20171174267–73Fredriksson T, Pettersson U. Severe psoriasis-oral therapy with a new retinoid. Dermatologica. 1978; 157 (4): 238–244Fredriksson T, Pettersson U. Severe psoriasis-oral therapy with a new retinoid. Dermatologica. 1978; 157 (4): 238–244Gift A. Validation of a vertical visual analogue scale as a measure of clinical dyspnea. Rehabilitation Nursing. 1989; 14: 313–35Gift A. Validation of a vertical visual analogue scale as a measure of clinical dyspnea. Rehabilitation Nursing. 1989; 14: 313–35Hamilton M. A rating scale for depression. J Neural Neurosurg Psychiatry. 1960; 23: 56–62.Hamilton M. A rating scale for depression. J Neural Neurosurg Psychiatry. 1960; 23: 56–62.Duvetorp A., Mrowietz U., Nilsson M., Seifert O. Sex and Age Influence the Associated Risk of Depression in Patients with Psoriasis: A Retrospective Population Study Based on Diagnosis and Drug-Use. Dermatology. 2021; 237: 595–602Duvetorp A., Mrowietz U., Nilsson M., Seifert O. Sex and Age Influence the Associated Risk of Depression in Patients with Psoriasis: A Retrospective Population Study Based on Diagnosis and Drug-Use. Dermatology. 2021; 237: 595–602Jing D., Xiao H., Shen M., et al. Association of Psoriasis with Anxiety and Depression: A Case-Control Study in Chinese Patients. Front Med (Lausanne). 2021; 8: 771645. https://doi.org/10.3389/fmed.2021.771645Jing D., Xiao H., Shen M., et al. Association of Psoriasis with Anxiety and Depression: A Case-Control Study in Chinese Patients. Front Med (Lausanne). 2021; 8: 771645. https://doi.org/10.3389/fmed.2021.771645Tian, Zhen, et al. A Chinese cross-sectional study on depression and anxiety symptoms in patients with psoriasis vulgaris. Psychology, health & medicine 24.3 (2019): 269–280Tian, Zhen, et al. A Chinese cross-sectional study on depression and anxiety symptoms in patients with psoriasis vulgaris. Psychology, health & medicine 24.3 (2019): 269–280Golpour M., Hosseini S.H., Khademloo M., et al. Depression and Anxiety Disorders among Patients with Psoriasis: A Hospital-Based Case-Control Study. Dermatol Res Pract. 2012; 2012: 381905. https://doi.org/10.1155/2012/381905Golpour M., Hosseini S.H., Khademloo M., et al. Depression and Anxiety Disorders among Patients with Psoriasis: A Hospital-Based Case-Control Study. Dermatol Res Pract. 2012; 2012: 381905. https://doi.org/10.1155/2012/381905Maiouak M., El Harch I., Chakri I., et al. Depression, Anxiety, and Quality of Life among Patients with Psoriasis: Prevalence, and Associated Factors. Open Access Library Journal. 2023; 10: 1–14. https://doi.org/10.4236/oalib.1109989Maiouak M., El Harch I., Chakri I., et al. Depression, Anxiety, and Quality of Life among Patients with Psoriasis: Prevalence, and Associated Factors. Open Access Library Journal. 2023; 10: 1–14. https://doi.org/10.4236/oalib.1109989Kurd S. K., Troxel A. B., Crits-Christoph P., Gelfand J. M. The risk of depression, anxiety, and suicidality in patients with psoriasis: a population-based cohort study. Arch Dermatol. 2010;146(8):891–5. https://doi.org/10.1001/archdermatol.2010.186.Kurd S. K., Troxel A. B., Crits-Christoph P., Gelfand J. M. The risk of depression, anxiety, and suicidality in patients with psoriasis: a population-based cohort study. Arch Dermatol. 2010;146(8):891–5. https://doi.org/10.1001/archdermatol.2010.186.Krishnadas R., Nicol A., Sassarini J., et al. Circulating tumour necrosis factor is highly correlated with brainstem serotonin transporter availability in humans. Brain Behav Immun. 2016; 51: 29–38. https://doi.org/10.1016/j.bbi.2015.08.005.Krishnadas R., Nicol A., Sassarini J., et al. Circulating tumour necrosis factor is highly correlated with brainstem serotonin transporter availability in humans. Brain Behav Immun. 2016; 51: 29–38. https://doi.org/10.1016/j.bbi.2015.08.005.Jaremka L.M., Lindgren M.E., Kiecolt-Glaser J.K. Synergistic relationships among stress, depression, and troubled relationships: insights from psychoneuroimmunology. Depress Anxiety. 2013;30(4):288–296. https://doi.org/10.1002/da.22078Jaremka L.M., Lindgren M.E., Kiecolt-Glaser J.K. Synergistic relationships among stress, depression, and troubled relationships: insights from psychoneuroimmunology. Depress Anxiety. 2013;30(4):288–296. https://doi.org/10.1002/da.22078Jin W., Zhang S., Duan Y. Depression Symptoms Predict Worse Clinical Response to Etanercept Treatment in Psoriasis Patients. Dermatology. 2019;235(1):55–64. https://doi.org/10.1159/000492784Jin W., Zhang S., Duan Y. Depression Symptoms Predict Worse Clinical Response to Etanercept Treatment in Psoriasis Patients. Dermatology. 2019;235(1):55–64. https://doi.org/10.1159/000492784Bouguéon K, Misery L. Depression and psoriasis. Ann Dermatol Venereol. 2008;135(Suppl 4):254–258.Bouguéon K, Misery L. Depression and psoriasis. Ann Dermatol Venereol. 2008;135(Suppl 4):254–258.Reich A., Mędrek K., Szepietowski J. C. Interplay of Itch and Psyche in Psoriasis: An Update. Acta Derm Venereol. 2016;96(217):55–7. https://doi.org/10.2340/00015555–2374.Reich A., Mędrek K., Szepietowski J. C. Interplay of Itch and Psyche in Psoriasis: An Update. Acta Derm Venereol. 2016;96(217):55–7. https://doi.org/10.2340/00015555–2374.D’Erme A.M., Zanieri F., Campolmi E., et al. Therapeutic implications of adding the psychotropic drug escitalopram in the treatment of patients suffering from moderate-severe psoriasis and psychiatric comorbidity: a retrospective study. J Eur Acad Dermatol Venereol. 2014; 28: 246–249.D’Erme A.M., Zanieri F., Campolmi E., et al. Therapeutic implications of adding the psychotropic drug escitalopram in the treatment of patients suffering from moderate-severe psoriasis and psychiatric comorbidity: a retrospective study. J Eur Acad Dermatol Venereol. 2014; 28: 246–249.Fabrazzo M., Romano F., Arrigo M. P. Multivariate Analysis of Depression Prevalence in Psoriasis Patients: A Cohort Study. Int J Environ Res Public Health. 2022;19(4):2060Fabrazzo M., Romano F., Arrigo M. P. Multivariate Analysis of Depression Prevalence in Psoriasis Patients: A Cohort Study. Int J Environ Res Public Health. 2022;19(4):2060Miller A.H. Beyond depression: The expanding role of inflammation in psychiatric disorders. World Psychiatry. 2020; 19: 108–109. https://doi.org/10.1002/wps.20723Miller A.H. Beyond depression: The expanding role of inflammation in psychiatric disorders. World Psychiatry. 2020; 19: 108–109. https://doi.org/10.1002/wps.20723Ahmad Fuat M. S., Mat Yudin Z., Muhammad J., Mohd Zin F. Quality of Life and Its Associated Factors among Patients with Psoriasis in a Semi-Urban North-east Malaysia. Int J Environ Res Public Health. 2022;19(18):11578. https://doi.org/10.3390/ijerph191811578Ahmad Fuat M. S., Mat Yudin Z., Muhammad J., Mohd Zin F. Quality of Life and Its Associated Factors among Patients with Psoriasis in a Semi-Urban North-east Malaysia. Int J Environ Res Public Health. 2022;19(18):11578. https://doi.org/10.3390/ijerph191811578Balato A., Schiattarella M., Di Caprio R., et al. Effects of adalimumab therapy in adult subjects with moderate-to-severe psoriasis on Th17 pathway. J Eur Acad Dermatol Venereol. 2014;28(8):1016–24. https://doi.org/10.1111/jdv.12240Balato A., Schiattarella M., Di Caprio R., et al. Effects of adalimumab therapy in adult subjects with moderate-to-severe psoriasis on Th17 pathway. J Eur Acad Dermatol Venereol. 2014;28(8):1016–24. https://doi.org/10.1111/jdv.12240Смольянникова В. А., Карамова А. Э., Нефедова М. А. Роль IL-17А и нейтрофильных гранулоцитов в патогенезе псориаза. Архив патологии. 2020; 82 (1): 30–37. https://doi.org/10.17116/patol20208201130.Smolyannikova V. A., Karamova A. E., Nefedova M. A. The role of IL-17A and neutrophil granulocytes in the pathogenesis of psoriasis. Pathology archive. 2020; 82 (1): 30–37 (In Russ.). https://doi.org/10.17116/patol20208201130.

The authors declare that there are no conflicts of interest present.