Depresión en pacientes con psoriasis y su impacto en la calidad de vida.

Abstract

Psoriasis is a chronic, systemic, and recurrent inflammatory disease with multiple comorbidities, affecting 2-3% of the population and causing various complications such as systemic and local inflammation and functional limitations. Although it is distributed worldwide, accurate statistics are not available in Ecuador. Its pathogenesis is influenced by both innate and adaptive immune responses, leading to the concomitant production of stress and anxiety. TNF-alpha activates the hypothalamic-pituitary-adrenal axis and indoleamine 2,3-dioxygenase, resulting in tryptophan depletion and, consequently, causing depression. Various factors contribute to depressive disorders in psoriasis patients, including psychological factors such as concerns about personal appearance, emotional distress, feelings of shame, low self-esteem, stigmatization, social exclusion, and work-related difficulties, leading to worsened coping mechanisms for the disease and greater impact on treatment adherence and efficacy. Objective: To analyze the bidirectional relationship between depression and psoriasis, identifying how each of these medical conditions can affect the other. This aims to provide a comprehensive understanding of how this interaction influences the quality of life of affected patients, with the intention of integrating psychodermatological interventions to improve their quality of life. Methods: This systematic review was conducted through various databases, including SciELO, PubMed, Springer, and Google Scholar. Results: The complex bidirectional relationship between psoriasis and depression should be addressed with a comprehensive and personalized approach, considering both the physical aspects of the disease and psychological factors. Conclusion: Currently, there is no definitive treatment for this condition, so management is symptomatic and palliative.