New Meta-Review Highlights Prevalence and Psychological Burden of Psoriatic Arthritis

A new overview of systematic reviews published in Rheumatology International consolidates existing data on the global prevalence, incidence, and psychological comorbidities associated with psoriatic arthritis (PsA), offering dermatologists a clearer picture of its epidemiologic footprint and emotional toll.

According to the analysis, which followed the Preferred Reporting Items for Overviews of Reviews, or PRIOR, guidelines, PsA remains a significant burden both in the general population and among patients with psoriasis. The pooled prevalence of PsA was estimated to range from 0.13% to 0.15% in the general population and from 15.5% to 19.7% in individuals with psoriasis.

The study also reported incidence rates ranging from 8.26 to 9.27 cases per 100,000 inhabitants annually in general populations. Notably, individuals with hidradenitis suppurativa had a reported PsA incidence of 0.87 cases, highlighting cross-condition relevance.

In addition to prevalence and incidence, the overview emphasized the psychological comorbidities that accompany PsA. Pooled prevalence rates were found to be 11.9% to 20% for depression, 19% to 33% for anxiety, 38% for alexithymia, and 72.9% for poor sleep quality. The incidence of depression in patients with PsA was also quantified, with a rate of 21.3 per 1,000 person-years.

"Depression and anxiety symptoms may be present in some patients with PsA," the authors stated, pointing to the need for psychosocial screening in clinical practice.

Importantly, the study uncovered geographic disparities in epidemiological data, suggesting variation in PsA burden by continent. Methodological inconsistencies were also identified in the existing literature, with several systematic reviews showing poor reporting across key A MeaSurement Tool to Assess systematic Reviews, or AMSTAR-2, items.

The authors concluded that “PsA seems to be prevalent and incident not only in people with psoriasis, but also in general population,” and emphasized the role of psychological symptoms in disease burden.

For practicing dermatologists, these findings reinforce the importance of early PsA screening in patients with psoriasis and a multidisciplinary approach that includes mental health evaluation. The data may also inform clinical vigilance in non-psoriatic populations where PsA may still arise.

Reference
Hernández-Rodríguez JC, Infante-Cano M, García-Muñoz C, Matias-Soto J, Martinez-Calderon J. Psoriatic arthritis with psychological comorbidities: an overview of systematic reviews on incidence, prevalence, and geographic disparities. Rheumatol Int. 2024;44(11):2337-2355. doi:10.1007/s00296-024-05617-1