Patients with psoriasis more likely to have obsessive-compulsive disorder

Key takeaways:

• Individuals with psoriasis had a higher likelihood of also having obsessive-compulsive disorder vs. healthy controls (1.4% vs. 0.7%).
• Jeffrey M. Cohen, MD, weighed in on possible reasons for this association.

A new study further confirmed the association between obsessive-compulsive disorder and psoriasis, stressing the need for dermatologists to be vigilant.

Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder that causes individuals to experience repetitive intrusive thoughts which cause compulsive behaviors. Although researchers are not sure why, past literature has found an association between this psychiatric disorder and psoriasis.

“Identifying associations between two disorders can provide a deeper understanding of both conditions and may lead to further research to explore whether certain treatments may be best for individuals with both diseases,” Jeffrey M. Cohen, MD, director of the Psoriasis Treatment Program, director of the safety department of dermatology and assistant professor of dermatology and biomedical informatics and data science at Yale School of Medicine, told Healio.

In an effort to confirm these findings and further help sufferers, Cohen and colleagues conducted a study examining the association between these two disorders. The data used were pulled from the NIH All of Us research program, which contains a diverse cohort of over 250,000 surveyed American adults.

Out of the 250,000 cases available in the database, the researchers matched 5,659 individuals (mean age, 62.6 years; 60.5% women), who had available electronic health records and were diagnosed with psoriasis, to 22,636 controls.

Results showed that individuals with psoriasis had a higher likelihood of also having OCD vs. matched controls who did not have psoriasis (1.4% vs. 0.7%; P < .001). In fact, there was 2.11-fold increased odds (95% CI, 1.6-2.74) of OCD among individuals with psoriasis compared with controls.

After adjusting for age, sex, race, ethnicity, income, smoking and depression, the link between OCD and psoriasis remained significant with an adjusted odds ratio of 1.57 (95% CI, 1.18-2.06).

According to the researchers, there are multiple hypotheses for why OCD and psoriasis share this association.

“Certain inflammatory cytokines that are known to be important in psoriasis, such as TNF-alpha, have also been shown to be elevated in people with OCD,” Cohen said. “Additionally, studies have shown that relatives of patients with OCD have increased rates of immune-mediated disorders, including psoriasis, suggesting a possible genetic link.”

Ultimately, Cohen said that the reasons are not well understood and require further research. Nevertheless, he also stressed that dermatologists must be aware of this association in case patients with psoriasis present OCD symptoms and require multidisciplinary intervention.

“The most important thing dermatologists can do is to be mindful of this association so that they can identify behaviors that may raise concern for OCD,” he told Healio. “This will allow for early referral and treatment by mental health professionals, which will ultimately lead to optimal comprehensive care for our patients.”

For more information:

Jeffrey M. Cohen, MD, can be reached at jeffrey.m.cohen@yale.edu.