Researchers at Yale School of Medicine have discovered a connection between psoriasis and obsessive-compulsive disorder (OCD), which could significantly impact dermatology practices.
This study, published on May 25 in the Archives of Dermatological Research, used data from the NIH’s All of Us Research Program, which collects health information from a wide range of U.S. patients.
Using surveys and electronic health records from over 250,000 participants, the researchers found that people with psoriasis have a 1.5 times higher chance of being diagnosed with OCD.
Psoriasis is an inflammatory skin condition characterized by scaly plaques and affects more than 8 million Americans. OCD is a mental health disorder marked by obsessive thoughts and compulsions, affecting 2 to 3 million people in the U.S.
Jeffrey Cohen, MD, assistant professor of dermatology and the study’s principal investigator, is interested in the intersection of psychiatric and inflammatory skin diseases.
He believes dermatologists could play a crucial role in identifying and referring patients with potential mental health issues.
Possible Explanations for the Link
There are several reasons why psoriasis and OCD might be linked. The symptoms of psoriasis, such as chronic itching, sleep problems, and disfigurement, could increase the risk of developing OCD.
Additionally, behaviors associated with OCD, like excessive bathing or handwashing, could worsen psoriasis.
“Too much bathing can dry out the skin and trigger psoriasis. The itching from psoriasis can lead to compulsive scratching,” says Cohen.
Inflammation may also be a factor. Both psoriasis and OCD are linked to high levels of inflammatory cytokines, like IL-2, IL-6, and TNF-α, which are part of the body’s immune response.
Genetic evidence shows that family members of people with OCD have higher rates of immune-mediated diseases, including psoriasis.
Diverse Data and Significant Findings
Although previous studies in Taiwanese and Swedish populations had found a similar OCD-psoriasis link, this is the first study to demonstrate the connection in American adults.
The All of Us database provided the researchers with health information from a diverse group of U.S. patients, including those often underrepresented in biomedical research.
“The All of Us database is fantastic for this research because it includes data from a wide range of people across the U.S., making the findings more powerful,” Cohen explains.
Integrating Mental Health into Dermatology
Cohen has been using the All of Us data since 2021 to uncover other associations, such as links between eczema and eating disorders, and between atopic dermatitis and OCD.
His research highlights the strong connection between skin conditions and mental health, an area often overlooked in dermatology.
“In dermatology, we often don’t ask about mental health issues that might be relevant,” Cohen says. “If we identify a potential risk, we can start the process of getting the patient evaluated and treated for their mental health, in addition to their skin condition.”
Dermatologists frequently see their patients, putting them in a good position to spot mental health concerns early. Increasing awareness of research findings that link skin and mental health could benefit both dermatologists and their patients.
By doing so, dermatologists can provide more comprehensive care and help improve their patients’ overall well-being.
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The research findings can be found in Archives of Dermatological Research.
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