Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
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Depression and anxiety
The Impact of Psoriasis Treatment on Depression and Suicide Risk: A Systematic Review
BACKGROUND: Psoriasis is a long-lasting inflammatory condition of the skin associated with various comorbidities, including depression and suicidal ideation. Management strategies for psoriasis include symptom alleviation, quality-of-life enhancement, and prevention of disease progression. Psoriasis treatments include topical therapies, phototherapy, oral systemic medications, and biologics. OBJECTIVES: In this review, we evaluate the impact of psoriasis treatments on depression and suicidal ideation in affected patients. METHODS: We systematically searched multiple databases, including PubMed, Scopus, and Web of Science, until September 30, 2024, to identify relevant articles. Studies that examined the effects of psoriasis therapies on depression and suicidal thoughts were included. Data on treatment modalities, psychological health outcomes, and psoriasis severity was obtained. Quality evaluation instruments, such as JBI, consolidated standards of reporting trials (CONSORTs), Center for Evidence-Based Management (CEMBa), and appraisal tool for cross-sectional studies (AXIS), were used to appraise study quality. RESULTS: Ten studies met inclusion criteria, predominantly focusing on biologic therapies. Biologics like guselkumab, brodalumab, and bimekizumab have shown notable reductions in depression symptoms, probably through the alleviation of psoriasis severity and the enhancement of quality-of-life. Suicidal ideation occurred in some cases, especially with brodalumab; however, a definitive causal relationship was not established. CONCLUSIONS: Treatments for psoriasis, especially biologics, have shown some advantages in reducing depression symptoms as well as relieving skin symptoms. However, cautious monitoring is required due to the possible hazards of suicidal thoughts with certain therapeutic options such as biologics. Addressing the complex issues of psoriasis requires comprehensive therapy that includes dermatologists and mental health specialists.
13 July 2026
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Novel and existing therapeutic interventions in psychogenic pruritus.
Psychogenic pruritus (PP) is a chronic itch disorder associated with psychological conditions lacking any dermatological or systemic cause. Diagnosis relies on excluding other aetiologies and identifying psychological stressors. Treatments include dermatological and psychiatric interventions such as topical steroids, selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, antihistamines, antipsychotics and psychotherapy. However, efficacy remains inconsistent, necessitating a systematic review of current and emerging pharmacological options. This study reviews pharmacological treatments for PP published in the past decade, evaluating efficacy and therapeutic potential. A systematic literature search was conducted using PubMed, Embase and Google Scholar (November 2014 to November 2024) following the PRISMA guidelines (PROSPERO: 1000201). In total, 1034 articles were screened by two independent reviewers. Inclusion criteria focused on human studies evaluating pharmacological treatments for PP. Seven studies met the inclusion criteria. Levels of evidence were assessed using the Joanna Briggs Institute critical appraisal checklist. SSRIs, particularly escitalopram, showed symptom improvement in case reports. Naltrexone (an opioid antagonist) led to complete itch resolution in a patient refractory to SSRIs. Gabapentin reduced pruritus severity. A neurokinin-1 receptor (NK-1R) antagonist (serlopitant) demonstrated significant efficacy in a phase II trial. Biologics such as dupilumab showed promise in chronic pruritus. Targeted therapies, including SSRIs, naltrexone, opioid pathway modulators, NK-1R antagonists and biologics, show promise in the clinical management of PP, but further research through randomized controlled trials is necessary to establish their efficacy and optimize treatment strategies.
27 May 2026
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