Impact of Psychological Factors on Early vs. Late-Onset Psoriasis: A Comparative Analysis

Abstract

Introduction: Psoriasis is a chronic inflammatory disease that significantly impacts psychosocial well-being. This study compares clinical and psychosocial characteristics between early-onset (<40 years) and late-onset (≥40 years) psoriasis patients.

Methods: This cross-sectional study included 190 psoriasis patients categorized as early-onset (n=135) and late-onset (n=55). Data on demographics, clinical features, comorbidities, and psychosocial factors were collected. The Hospital Anxiety and Depression Scale (HAD) and the Dermatology Life Quality Index (DLQI) assessed psychological impact and quality of life. Statistical analyses included chi-square tests, t-tests, and correlation analyses.

Results: Early-onset patients were more likely to have a family history of psoriasis (43.7% vs. 16.4%, p<0.001), while pustular psoriasis was more common in the late-onset group (27.3% vs. 11.1%, p=0.006). A significant positive correlation was observed between DLQI scores and HAD-Total, HAD-Anxiety, and HAD-Depression scores (p<0.001). Psychological stress was reported as a disease trigger by 63.1% of patients, with a higher proportion in the early-onset group (p=0.025). Although DLQI and HAD scores did not significantly differ between groups, early-onset patients showed greater stress sensitivity.

Conclusions: Early-onset psoriasis patients are more likely to report stress as a trigger and have a family history, while late-onset patients exhibit higher rates of pustular psoriasis and increased BMI. These findings highlight the need for tailored management strategies to address the distinct clinical and psychosocial needs of early and late-onset psoriasis patients. Future research should focus on longitudinal studies to further explore these relationships.