Sex differences in the association between depression and PsO: An NHANES database study

Results from a cross-sectional study investigating the association between depressive symptoms and psoriasis (PsO) in 15,863 patients using data from the National Health and Nutrition Examination Survey (NHANES; 2009–2014) were published in Medicine by Wen et al. The aim of this study was to evaluate sex differences in the relationship between depression and PsO. Three regression models were constructed: Model 1, in which no adjustments were applied; Model 2, in which age, gender, race, body mass index (BMI), income-to-poverty ratio (PIR), and education level were considered; and Model 3, in which age, gender, race, BMI, PIR, education level, drinking behavior, and smoking habits were considered. 

Key data: A robust association between higher Patient Health Questionnaire-9 (PHQ-9) scores and PsO was identified in Model 1 (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.02–1.06; p < 0.001), Model 2 (OR, 1.05; 95% CI, 1.02–1.07; p = 0.001), and Model 3 (OR, 1.04; 95% CI, 1.01–1.07; p = 0.01) vs patients without depression. In subsequent analyses, using a PHQ-9 threshold score ≥5, an association between depression and PsO was confirmed with Model 1 (p = 0.004), Model 2 (p = 0.01), and Model 3 (p = 0.01). Males with depression exhibited an elevated likelihood of PsO onset (p < 0.001), with the OR of PsO increasing with higher PHQ9 scores (p < 0.001), whereas no statistically significant association was observed in females. 

Key learning: Higher PHQ-9 scores were positively associated with PsO prevalence, with a sex-specific effect observed exclusively in males, highlighting the importance of monitoring PsO occurrence and implementing early screening in men with depression.