Psychiatric Comorbidity and Suicidal Ideation Among Adults with Psoriasis: A Cross-Sectional Study.

Abstract

Introduction: Psoriasis is a chronic inflammatory skin disorder frequently associated with psychological distress, impaired quality of life, and increased risk of suicidal behavior. This study was conducted to assess quality of life, psychiatric comorbidity, and suicidal ideation among patients with psoriasis and identify factors associated with suicidal ideation. Methods: A hospital-based cross-sectional study was conducted among 216 adult patients with clinically diagnosed psoriasis attending a tertiary care teaching hospital. Sociodemographic and clinical information were collected using a structured questionnaire. Disease severity was assessed using PASI, quality of life using DLQI, depression using PHQ-9, anxiety using GAD-7, and suicidal ideation using PHQ-9 item 9 and C-SSRS. Data were analysed using descriptive statistics, chi-square tests, and multivariable logistic regression. Results: Among the participants, 61.1% were male and the mean age was 40.2±12.1 years. Nearly half (49.1%) had disease duration >5 years, while scalp involvement (45.4%), nail involvement (33.3%), and topical therapy (57.4%) predominated. Moderate-to-very large impairment in quality of life was observed in 66.6% of patients. Moderate-to-severe depressive symptoms and anxiety symptoms were present in 25.0% and 16.7% of participants, respectively. Suicidal ideation was reported by 16.7% of patients; among them, 61.1% had passive ideation, 27.8% had active ideation without intent, and 11.1% had active ideation with intent or plan. Moderate-to-severe depression (aOR=5.6; 95% CI: 2.4–12.9), large/very large DLQI impairment (aOR=2.8; 95% CI: 1.3–6.2), and higher internalized stigma (aOR=1.4; 95% CI: 1.0–1.9) were independent predictors of suicidal ideation. Conclusions: Psoriasis is associated with significant impairment in quality of life, psychiatric morbidity, and suicidal ideation. Routine mental health screening and integrated dermatological and psychiatric care are essential to improve patient outcomes.