Study Finds Distinct Psychosocial Burdens in Early- vs Late-Onset Psoriasis

A new cross-sectional study comparing early-onset (<40 years) and late-onset (≥40 years) psoriasis highlights key clinical and psychosocial differences that may inform individualized care strategies for dermatologists.

Among 190 patients, early-onset psoriasis was more strongly associated with family history (43.7% vs 16.4%, P<0.001) and psychological stress as a disease trigger (63.1% overall, P=0.025). In contrast, late-onset patients with psoriasis had higher rates of pustular psoriasis (27.3% vs 11.1%, P=0.006) and elevated body mass index.

The study used the Hospital Anxiety and Depression Scale (HADS) and Dermatology Life Quality Index (DLQI) to assess psychosocial impact. While no overall differences were found in psychological scores between early- and late-onset groups, further analysis of patients with chronic plaque psoriasis revealed significantly higher anxiety and total HADS scores in the early-onset group (P=0.002 and P=0.035, respectively).

“Early-onset patients with chronic plaque psoriasis experience greater psychological burden, particularly anxiety,” the authors reported. They also observed a strong relationship between quality of life and mental health across all patients. “A significant positive correlation was observed between DLQI scores and HADS-Total, HADS-Anxiety, and HADS-Depression scores (P<0.001).”

These findings support integrating age of onset and clinical subtype into psychosocial screening and management. Early-onset patients may benefit from proactive anxiety assessment and targeted mental health support, especially those with chronic plaque disease.

“Early-onset patients with psoriasis are more likely to report stress as a trigger and have a family history, while late-onset patients exhibit higher rates of pustular psoriasis,” the authors concluded. Dermatologists should consider these distinctions when developing comprehensive care plans that address both physical and psychological aspects of the disease.

Reference
Yildrim EA, Polat M. Impact of psychological factors on early vs. late-onset psoriasis: a comparative analysis. Dermatol Pract Concept. 2025; 15(3):5249. doi:10.5826/dpc.1503a5249