Evidence map›Paper›PMID 33009969›Full record

ArticleClinical rheumatology2021

Psoriatic arthritis and depressive symptoms: does systemic inflammation play a role?

Enrico De Lorenzis, Gerlando Natalello, Dario Bruno, Giacomo Tanti, Maria Rosaria Magurano, Donatella Lucchetti, Clara Di Mario, Barbara Tolusso, Giusy Peluso, Elisa Gremese

Abstract read
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In one paragraph

Article in Clinical rheumatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 12 citations in OpenAlex.

  1. Review
  2. Review
  3. Molecular Link Between Psoriasis and Depression-Update on Pathophysiology.International journal of molecular sciences · 2025
    Review
  4. Article
  5. Article
  6. Article
  7. Observational
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Enrico De LorenzisDivision of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy.
Gerlando NatalelloDivision of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy.
Dario BrunoDivision of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy.
Giacomo TantiDivision of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy.
Maria Rosaria MaguranoHospital Service of Clinical Psychology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Donatella LucchettiDepartment of Translational Medicine and Surgery, Catholic University of the Sacred Heart, Rome, Italy.
Clara Di MarioDivision of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy.
Barbara TolussoDivision of Rheumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Giusy PelusoDivision of Rheumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Elisa GremeseDivision of Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy. elisa.gremese@unicatt.it.ORCID https://orcid.org/0000-0002-2248-1058
Università Cattolica del Sacro Cuore · ITAgostino Gemelli University Polyclinic · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesDepression is commonly associated with psoriatic arthritis (PsA), but its risk factors in these patients are largely unrecognized. Pro-inflammatory cytokines involved in the pathogenesis of PsA have been associated with depression in patients without autoimmune diseases. The aim of this study was to establish whether PsA patients with and without depressive symptoms differed for general or clinical variables and serum cytokines milieu.

methodsOne hundred and fifty consecutive patients with PsA were screened for depressive symptoms with Hospital Anxiety and Depression Scale (HADS-D). Patients with and without depressive symptoms were compared according to the prevalence of general risk factors for depression, comorbidities, PsA features and serum IL-6, TNF-α, and IL-17A.

resultsFifty-eight patient (38.7%) had a depressive mood. Depressive symptoms were associated with female sex (p = 0.03) and current smoking (p = 0.05). Patients with and without depressive symptoms did not differ for general risk factors for depression and comorbidities. Depressed patients had more frequently psoriatic nail disease (p = 0.02) and significant physical disability (HAQ-DI ≥ 0.5) (p < 0.01) and were more frequently in moderate or high disease activity according to DAPSA score (p = 0.01). Depressed patients had higher serum IL-6 (p < 0.01) and comparable serum IL-17A and TNF-α. A cutoff of 2.27 pg/ml of serum IL-6 had the best ability to predict an HADS-D ≥ 8 (AUC 0.666 ± 0.044; p < 0.01). Multivariate logistic regression analysis confirmed that serum IL-6 ≥ 2.27 pg/ml was independently associated with depressive symptoms (OR 3.5; CI 1.6-7.8; p < 0.01).

conclusionsHigher serum Il-6 is associated with depressive symptoms. This association suggests a direct role of systemic inflammation in the modulation of mood in PsA patients. Key Points • High PsA disease activity and physical disability are associated with depression. • Higher serum levels of IL-6 are independently associated with depression in PsA. • IL-6 might play a direct role in the development of depression in PsA patients.

Indexed as

Arthritis, PsoriaticDepressionCytokinesFemaleHumansInflammationTumor Necrosis Factor-alphaCytokinesTumor Necrosis Factor-alphaDepressionInterleukin-17AInterleukin-6Psoriatic arthritisTumor necrosis factor α

Identifiers

PMID33009969
OpenAlexW3090417486

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.