Exploring the Inflammatory Link Between Psoriasis and Psychiatric Comorbidities

A recent review, published in Acta Physiologica, highlights growing evidence that systemic inflammation, mediated by proinflammatory cytokines and neuropeptides, plays a key role in the interplay between psoriasis vulgaris and psychiatric conditions such as depression, anxiety, and chronic stress.

The literature review analyzed studies focusing on inflammatory cytokines—including interferon-γ, interleukin (IL)-1, IL-2, IL-6, IL-12, tumor necrosis factor-α, IL-22, and IL-17—and neuropeptides, such as calcitonin gene-related peptide, substance P, and vasoactive intestinal peptide. These mediators, along with dysfunction of the hypothalamic-pituitary-adrenal axis, appear central in linking psychological stress with inflammatory skin disease.

"Existing literature indicates that psychiatric state can influence cutaneous conditions through immune, neural, and endocrine mediators," the authors noted.

Elevated rates of psychiatric comorbidities among patients with psoriasis are attributed not only to the psychosocial burden of visible skin disease but also to shared inflammatory pathways.

Importantly for dermatology practice, the review emphasized that "the elevated rates of anxiety and depression observed in patients with psoriasis are likely due to both the inflammatory process itself and the chronic stress associated with disease management," reinforcing the need for a multidisciplinary approach to patient care.

The findings suggest that addressing mental health and stress reduction may be critical adjuncts to controlling skin inflammation. However, the authors cautioned that "further research is necessary to continue to elucidate physiological mechanisms and explore the potential for new treatment modalities."

For clinicians, integrating mental health support and stress management into psoriasis care strategies may improve both dermatologic and psychological outcomes.

Reference
Keenan EL, Granstein RD. Proinflammatory cytokines and neuropeptides in psoriasis, depression, and anxiety. Acta Physiol (Oxf). 2025;241(3):e70019. doi:10.1111/a