OBJECTIVE: (1) To determine the prevalence of depression and anxiety in patients 
with psoriatic arthritis (PsA) and to identify associated demographic and 
disease-related factors. (2) To determine whether there is a difference in the 
prevalence of depression and anxiety between patients with PsA and those with 
psoriasis without PsA (PsC).
METHODS: Consecutive patients attending PsA and dermatology clinics were 
assessed for depression and anxiety using the Hospital Anxiety and Depression 
Scale. Patients underwent a clinical assessment according to a standard protocol 
and completed questionnaires assessing their health and quality of life. T 
tests, ANOVA, and univariate and multivariate models were used to compare 
depression and anxiety prevalence between patient cohorts and to determine 
factors associated with depression and anxiety.
RESULTS: We assessed 306 patients with PsA and 135 with PsC. There were 
significantly more men in the PsA group (61.4% vs 48% with PsC) and they were 
more likely to be unemployed. The prevalence of both anxiety and depression was 
higher in patients with PsA (36.6% and 22.2%, respectively) compared to those 
with PsC (24.4% and 9.6%; p = 0.012, 0.002). Depression and/or anxiety were 
associated with unemployment, female sex, and higher actively inflamed joint 
count as well as disability, pain, and fatigue. In the multivariate reduced 
model, employment was protective for depression (OR 0.36) and a 1-unit increase 
on the fatigue severity scale was associated with an increased risk of 
depression (OR 1.5).
CONCLUSION: The rate of depression and anxiety is significantly higher in 
patients with PsA than in those with PsC. Depression and anxiety are associated 
with disease-related factors.