Childhood trauma: A factor for increased risk of major depression in psoriatic patients

Abstract

A history of childhood maltreatment (CM) is an important determinant for understanding the development of psychiatric and physical disorders. CM is associated with sensitization of central nervous system (CNS) that leads to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis [1]. Early life stress is a well-known contributor to major depression [2]. The dysregulation of HPA axis and sympathetic nervous system activity also impact skin. Epidermis shows a high vulnerability to such psychological stressors resulting to increase risk for psoriasis [3]. The current study investigates the association between childhood trauma and major depression, childhood trauma and psoriasis, and also severity of major depression in female and male patients with psoriasis. Sixty-four psoriatic patients (female = 34, mean age = 46.87) were evaluated with the Childhood Trauma Questionnaire (CTQ) for the history of CM and with the MINI International Neuropsychiatric Interview for the diagnosis of major depression. CM was associated with major depression, indexed by a higher CTQ in emotional (χ²(3) = 26.002, P < .0005) and physical abuse scores (χ²(3) = 23.764, P < .0005). CM limited to sexual abuse was associated with higher severity of psoriasis (χ²(3) = 9.81, P < .02). There was no indication of a difference between men and women in severity of major depression (U = 444, P = .304). Our findings highlight the importance of recognizing psychiatric comorbidity, in particular major depression, among psoriatic patients. Depressive disorder with the presence of psoriasis may constitute a separate etiology with a greater contribution of early environment.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.