Background: Psoriatic arthritis is often accompanied by significant comorbidity including increased cardiovascular disease. Rheumatic diseases like rheumatoid arthritis and systemic lupus erythematosus are associated with increased prevalence of depression and anxiety. The same is true in psoriasis. In psoriatic arthritis, the combination of inflammatory arthritis in addition to psoriasis is likely to contribute to a greater burden of depression and anxiety, however the extent remains unclear. Treatments for psoriatic arthritis may therefore also benefit comorbid depression and anxiety and warrants further exploration.
Methods: We will perform a systematic review in accordance with PRISMA guidelines examining prevalence of depression and anxiety in psoriatic arthritis as well as effects of treatment for psoriatic arthritis on these psychiatric comorbidities. We will search MEDLINE, EMBASE, EBM Reviews and Cochrane, and PsycINFO from inception to September 2017 inclusive. Only original human studies published in English will be eligible, with exclusion of letters, abstracts and case series. Strength of studies will be assessed using a GRADE approach. Study and population characteristics will be extracted from included articles using a pre-determined data collection tool and entered into an electronic database for subsequent analysis.
Discussion: This will be the first systematic review of prevalence of depression and anxiety in patients with psoriatic arthritis. This has implications for screening these comorbidities in patients with psoriatic arthritis. Screening is only meaningful if we have effective treatments for these comorbidities and this study will also help illustrate the evidence for treatment of depression and anxiety in patients with psoriatic arthritis.