Effect of biologics on depressive symptoms in patients with psoriasis: a systematic review

J Eur Acad Dermatol Venereol. 2015 Jun;29(6):1063-70. doi: 10.1111/jdv.12909. Epub 2014 Dec 10.


Background: Twenty to fifty percent of patients with psoriasis have depressive symptoms.

Objective: To describe the effects of biologics (tumour necrosis factor inhibitors [TNFi] or interleukin 12/23 inhibitors [IL-12/23i]) on depressive symptoms in patients with psoriasis.

Methods: Electronic databases were searched for randomized controlled trials (RCTs) examining the effects of biologics on depressive symptoms in adults with psoriasis.

Results: Of the 305 publications identified, three RCTs were included in a systematic review. In a trial evaluating ustekinumab, mean change in Hospital and Anxiety Depression Rating Scale at 24 weeks from baseline was 3.1 with ustekinumab (P < 0.001) vs. 0.21 with placebo (not significant). In a trial evaluating adalimumab, mean change in Zung Self-Rating Depression Scale at 12 weeks from baseline was -6.7 with adalimumab vs. -1.5 with placebo. In a trial evaluating etanercept, the between-group difference at 12 weeks in Beck Depression Inventory Scale was 1.8 (95% CI: 0.6, 2.90) in favour of etanercept over placebo. Limitations are that diagnostic criteria for depression were not used and scales and data from individual RCTs could not be combined.

Conclusion: Adalimumab, etanercept and ustekinumab were associated with statistically significant reductions in depressive symptom scores using various scales in patients with moderate-to-severe psoriasis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adalimumab / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Depression / drug therapy
  • Depression / etiology*
  • Dermatologic Agents / therapeutic use
  • Etanercept / therapeutic use*
  • Humans
  • Psoriasis / drug therapy*
  • Psoriasis / psychology*
  • Psychiatric Status Rating Scales
  • Randomized Controlled Trials as Topic
  • Ustekinumab / therapeutic use*


  • Anti-Inflammatory Agents, Non-Steroidal
  • Dermatologic Agents
  • Ustekinumab
  • Adalimumab
  • Etanercept