The role of psychological factors in the manifestation and exacerbation of psoriasis is well known. Acute and chronic stress, anxiety, and depression affect the reactions of innate and acquired immunity. The exacerbations of psoriatic lesions are accompanied by increased production of inflammatory mediators, which could contribute to the imbalance of neurotransmitters and the development of symptoms of depression and anxiety. The role of inhibitory neurotransmitters in the serum of patients with psoriasis exacerbation with comorbid emotional disorders is assessed. Forty patients with psoriasis in the exacerbation stage were examined. Spielberger State‐Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI) scale were used to assess anxiety and depression parameters. We also evaluated the concentration of serotonin and gamma‐aminobutyric acid (GABA) in the serum. Patients with psoriasis had significant anxiety and depressive disorders. An imbalance in serotonin levels and a decrease in serum GABA levels in patients with psoriasis in the acute stage were noted. Only patients with anxiety disorder had increased serotonin levels. Our findings suggest that the imbalance of neurotransmitters in patients with psoriasis in the acute stage is important in predicting the development of the emotional well‐being.

Psoriasis is associated with psychological comorbidities. We evaluated the effectiveness of additional psychopharmacotherapy on the clinical severity and associated anxiety and depression in psoriasis. 173 patients were enrolled with psoriasis and associated anxiety and depression. Spielberger State-Trait Anxiety Inventory (STAI) and The Beck Depression Scale (BDI) were used to assess anxiety and depression parameters. The IA main group included patients with anxiety disorders who received Mebicar. The IB main group consisted of patients with anxiety and depressive disorders who received Mianserin. The II group comprised patients with anxiety disorders (IIA comparison group) and patients with anxiety and depressive disorders (IIB comparison group), who received only traditional therapy. The level of anxiety in patients of the IA and IB main groups decreased by 2.1 times. The level of depression in the IB main group significantly decreased by 1.7 times, while in the IIB comparison group, this indicator remained almost at the same level. Patients of the IA and IB main

Резюме Тривалий виснажливий перебіг хронічних дерматозів з численними рецидивами призводить до надмірного напруження реактивних сил організму. Зниження якості життя пацієнтів, які страждають на псоріаз, обумовлена не лише клінічними проявами дерматозу, а й порушеннями психоемоційного стану. Мета: дослідити асоційовані психоемоційні порушення у хворих на псоріаз у стадії загострення, визначити їх вплив на якість життя хворих. Матеріали та методи: матеріали клініко-патопсихологічних досліджень (анкетування), статистичні методи. Було обстежено 234 хворих на поширений псоріаз у стадії загострення. Результати: Більшість пацієнтів (73,9%) мали асоційовані психоемоційні розлади: тривожні порушення-55,9% хворих, тривожно-депресивні-17,9%. Більшість пацієнтів (66,4%) з асоційованими психоемоційними порушеннями відчували дуже сильний та надзвичайно сильний їх вплив на якість життя. Висновки: Хворим на псоріаз притаманні асоційовані психоемоційні порушення, зокрема тривожні та тривожно-депресивні розлади. Асоційовані афективні розлади чинять значний вплив на якість життя хворих з поширеним псоріазом у стадії загострення, що обумовлює потребу в комплексному обстеженні та лікуванні таких хворих. Ключові слова: псоріаз, психоемоційні порушення, якість життя.

The objective: to optimize the treatment of patients with advanced psoriasis by applying a complex method that includes psychopharmacotherapy. Materials and methods. There were 163 patients with acute psoriasis aged 18 to 74 years, of which 88 were men (53.9%) and 74 were women (46.1%). All patients underwent a comprehensive clinical and laboratory examination in accordance with the guidelines. To determine the psychoemotional state, all patients with psoriasis were subjected to a pathopsychological examination: determination of the level of reactive anxiety (RA) on the Spielberger-Hanin scale. Patients with moderate to high levels of anxiety disorders were divided into two groups. The first therapeutic group (I Group, 74 people) consisted of patients who received the anxiolytic drug mebicar against the background of traditional therapy. The therapeutic comparison group (Group II, 72 people) was formed by patients who received only traditional therapy. Results. It was found that the average RT score among all patients was (50.9 ± 0.8), which corresponded to a high level. The majority of patients (85–52.2%) had high RA levels. At the end of the course of therapy with the developed method, patients of Group I had a statistically significant decrease in the level of RA by 1.4 times and a decrease in the average score to (35.2 ± 0.4) points. But in patients of Group II, the RA level also decreased, but only by 1.1 times (p < 0.05) and the average score was significantly higher compared to the indicator in Group I by 1.3 times. Patients in Group I had an improvement in the clinical manifestations of psoriasis (PASI50) on average (10.3 ± 0.1) days of treatment. A similar result was achieved in patients of Group II only on (15.5 ± 0.2) days, which is significantly later than in Group I. Consequently, the appointment of differentiated psychopharmacotherapy contributed to an earlier regression of clinical manifestations. Conclusions. It was found that the vast majority of patients with psoriasis had a high level of RA, which should be taken into account when prescribing complex therapy. The appointment of psychopharmacotherapy contributed to the normalization of the psychoemotional state and earlier regression of clinical manifestations (the PASI50 state was achieved on (10.3 ± 0.1) days of treatment, which is 5.2 days less than in patients who received only traditional therapy).

Резюме Метавивчення показників якості життя у хворих на алергодерматози у взаємозв'язку з рівнем психосоматичних порушень. Матеріали та методи. Під наглядом перебували 142 хворих на алергодерматози. У 84 хворих діагностовано загострення хронічної екземи, у 58атопічний дерматит. За шкалою тривоги Спілбергера-Ханіна оцінювали рівень реактивної тривожності, за шкалою Бекарівень депресії. Оцінку негативного впливу захворювання на якість життя хворих проводили за визначенням дерматологічного індексу якості життя (DLQI).