Erfanian, M; (2018) Childhood trauma: a risk for major depression in patients with psoriasis. Psychiatry and Clinical Psychopharmacology , 28 (4) pp. 378-385. 10.1080/24750573.2018.1452521.

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Abstract

INTRODUCTION: A history of childhood trauma is an important determinant for understanding the development of psychiatric and physical disorders. The chronic inflammatory disease, psoriasis, has been reported to be affected by childhood psychological stressors. Early life stress is also a well-known contributor to major depression. The current study aims to clarify a possible association between levels and types of childhood trauma with psoriasis severity and major depression. METHOD: Sixty-four patients diagnosed with mild-to-severe psoriasis (male = 27, mean age = 52.51 ± 14.72 years and female = 37, mean age = 42.76 ± 14.45 years, age range = 21–77) were admitted to our study between April 2014 and September 2014. For the diagnosis of psoriasis, the single most recently developed lesion was examined dermoscopically and histopathologically. We evaluated the history of childhood trauma with the Childhood Trauma Questionnaire and diagnosis of major depression with the Mini International Neuropsychiatric Interview (MINI 5.0.0 current). The participants were scanned for their severity of psoriasis with Psoriasis Area and Severity Index 75 (PASI 75). Initially, the data were checked for normality using Kolmogorov–Smirnov/Shapiro–Wilk’s tests, histograms, and probability plots. Because normality of the data could not be assumed, we evaluated childhood trauma subscales and psoriasis by running Kendell’s tau-b correlation coefficients for bivariate comparisons. Mann–Whitney U test was conducted to assess the differences in childhood trauma severity of each subscale between two groups of depressed and nondepressed patients with psoriasis. Ultimately, we ran chi-square analysis to evaluate the association between gender and depression. RESULTS: Emotional (0.325), physical (0.614), sexual (0.963) abuse, and emotional (0.331) neglect were positively correlated with higher severity of psoriasis (p < .01). Subsequently, emotional (U = 372, p = .43), physical (U = 387, p = .049), sexual (U = 297, p = .0005) abuse, emotional (U = 299.5, p = .001), and physical U = 372, p = .031) neglect were significantly higher in psoriasis patients with depression compared to non-depressed (p < .05). CONCLUSION: The findings of the current study underline the relationship between childhood trauma and major depression, as well as childhood trauma and psoriasis. The increased level of emotional, physical, sexual abuse, and emotional neglect was linked to elevated severity of psoriasis. Likewise, all childhood trauma subtypes appeared to be more severe in the group of psoriasis patients with major depression. Investigation of childhood traumatic experiences, and major depression in individuals with psoriasis, the screening of depressed patients for psoriasis, and the cross-referencing of the outcome can be expected to provide remarkable findings, new approaches for diagnosis and treatment, as well as implications for promulgating new legislation.

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