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Beyond joint disease, the toll of PsA negatively affects emotional, social, and mental health aspects of patients’ health-related quality of life.

Psoriatic arthritis (PsA) impacts patients beyond joint disease. According to a systematic review published in Therapeutic Advances in Musculoskeletal Disease, PsA also negatively affects the emotional, social, and mental health aspects of patients’ health-related quality of life (HRQOL).

“Therefore, we suggest that along with regular check-ups, it’s important to address patients’ emotional, social, and mental aspects with compassionate care,” wrote Laura Coates, PhD, and study coauthors.

The review included 37 comprehensive studies published between 2010 and 2021.

Overall, the review indicated that PsA affects numerous aspects of life, including activities of daily living, physical, and emotional facets such as fatigue, sleep disturbance, anxiety, and depression.

One-fifth of patients reported severe fatigue in one study, and more than two-thirds reported poor sleep in another. All 3 studies that used the Hospital Anxiety and Depression Scale found mild anxiety in patients with PsA. Moderate to severe depressive symptoms, meanwhile, affected 21.7% of patients with PsA and 36.7% of patients with PsA with polyarthritis, according to another investigation.

The review also found that HRQOL was generally lower in patients with PsA, particularly regarding emotions, social interactions, and mental well-being. Severe pain and fatigue were directly associated with decreased HRQOL.

“Moreover, if their disease was poorly controlled, it negatively affected work productivity and employment satisfaction scores,” the researchers reported. “Additionally, they reported difficulties with sleep, low mood, and challenges with sexual function.”

All studies in the review used outcomes validated in patients with PsA, but many of the measures were initially developed for other conditions or the wider population. Consequently, the adverse effect on QOL reported in the studies is likely underestimated, the researchers advised. Moreover, studies on the relationship among PsA, disease activity, and sleep disorders often struggle to provide conclusive results.

“Nevertheless, they draw attention to the impact that these disorders can have on patients,” researchers wrote, “which is a crucial aspect of their quality of life that is frequently overlooked in clinical practice.”