INTRODUCTION
Psoriasis is a chronic inflammatory skin condition affecting 2% to 3% of the world's population.1,2 The development of the characteristically pruritic plaques is driven by complex immune processes. Although topical therapies are among the first-line treatment options for mild psoriasis, many patients require phototherapy or systemic treatment, including oral and biologic drugs.3 Treatment options differ not only in their mechanisms of action and side-effect profiles but also in the time needed to achieve treatment results. When evaluating differences in the time to treatment response, it is important to consider the profound effect that psoriasis can have on health and quality of life, as well as how that may shape patient expectations and preferences regarding response time.
Mental health comorbidities of psoriasis are well established. In patients with psoriasis, depressive symptoms may emerge from a combination of chronic physical pain and discomfort and the social stigma attached to the appearance of skin lesions.4 Additionally, studies have suggested that the inflammatory milieu of psoriasis may be a causative link to depression.5 In a 2008 survey, 63% of individuals with psoriasis reported significant self-consciousness, and more than one-third reported avoiding social activities because of their psoriasis.6 For some patients, this psychosocial distress may occur alongside symptoms of clinical depression. For example, one large population analysis found that 28% of individuals with psoriasis experienced depressive symptoms and were 1.5 times more likely to have clinical depression compared with the general population.7 In a study of >2000 patients with psoriasis, 62% experienced some symptoms of depression.8 Although the etiology of depression in patients with psoriasis is complex, studies have shown statistically significant correlations between disease flares and
Mental health comorbidities of psoriasis are well established. In patients with psoriasis, depressive symptoms may emerge from a combination of chronic physical pain and discomfort and the social stigma attached to the appearance of skin lesions.4 Additionally, studies have suggested that the inflammatory milieu of psoriasis may be a causative link to depression.5 In a 2008 survey, 63% of individuals with psoriasis reported significant self-consciousness, and more than one-third reported avoiding social activities because of their psoriasis.6 For some patients, this psychosocial distress may occur alongside symptoms of clinical depression. For example, one large population analysis found that 28% of individuals with psoriasis experienced depressive symptoms and were 1.5 times more likely to have clinical depression compared with the general population.7 In a study of >2000 patients with psoriasis, 62% experienced some symptoms of depression.8 Although the etiology of depression in patients with psoriasis is complex, studies have shown statistically significant correlations between disease flares and
