Background/Purpose: As known chronic inflammatory diseases have an impact on sexuality. To date, there are only a few studies from North and Latin America which investigated the influence of inflammatory diseases on sexual life and practically none on patients with psoriasis (Pso) and psoriatic arthritis (PsA) (1-3). Reliable data on the prevalence of sexual dysfunction, quality of life and depression in this population compared to the general population are lacking.

Methods: Patients with psoriasis and psoriatic arthritis in two German tertiary university hospitals were evaluated with a self-designed questionnaire on various sexual and disease specific aspects, a 19-item version of the validated Female Sexual Function Index (FSFI), 15-item version of International Index of Erectile Function (IIEF), Dermatology Life Quality Index (DLQI), the 9-item questionnaire Qualisex, and the Beck’s depression inventory (BDI) in a prospective study. The study was approved by our ethics committee and all patients gave written informed consent.

This work was supported by an unrestricted grant by Novartis.

Results: 416 patients were included into the study. Among them 219 suffered from Pso, 94 being females (mean age 45 years) and 125 males (mean age 43 years), as well as 197 PsA patients, 80 being females (mean age 47.5 years) and 117 males (mean age 45 years). The Healthy Control Group (HCG) is composed of 87 women with a median age of 34 years (ranging from 18-64) and 119 men with a median age of 52 years (ranging from 20-69).

The prevalence of sexual dysfunction (SDF) was similarly high in patients with Pso and PsA (82.6 vs. 75.6%) and significantly lower in the HCG (44.8%, p= < 0.0001). Erectile Dysfunction did only differ significantly in younger patients (18-35 years) with moderate-severe manifestation and Pso or PsA (11.8 vs. 9.4%) and no affected men in the HCG (0%, p=0.05).

The prevalence of depression in this cohort was highest in female patients with psoriatic arthritis, with no significant increase compared to female patients with psoriasis (50.1 vs. 34.0%). In comparison, only 3.5% of the women in the healthy control group had depression, which was a highly significant difference (p=0.0001). A similar picture was seen in the male patients with Pso and PsA, with a lower prevalence of depression, especially the severe forms, compared to the female patients (23.2 vs. 29.9%). Here, too, there was a highly significant difference compared to the male control group with a prevalence of 8.5% (p=0.0001).

Conclusion: In this work, for the first time Pso and PsA were studied separately and together with regard to their influence on sexuality and possible depression in men and women and compared with a healthy control group. Our work shows the impact of chronic diseases, such as Pso and PsA, on the sexuality and mood of our patients in a large collective. In patients who suffer from additional articular disease in combination with skin disease, the proportion of erectile dysfunction and depression is particularly high. Physicians should pay more attention to these common comorbidities and consciously address during the medical consultations.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/prevalence-of-sexual-dysfunction-and-depression-in-german-patients-with-psoriasis-and-psoriatic-arthritis-results-of-the-pippa-study/