Objective: The aim of this longitudinal study is to compare different
dimensions of coping in psoriasis patients dependent on the development
of the severity of this chronic skin disease. For this purpose
we examined the patients’ coping and their skin state in a 1-year
follow-up. Methods: We assessed the severity of psoriasis with the
Psoriasis Area and Severity Index (PASI) and the Self-Administered
PASI (SPASI), and coping with the ‘Trier Coping with Illness Scales’
in 262 inpatients. The severity of psoriasis estimated with the
(S)PASI was defined as ‘mild’ ([S]PASI 0.0 - 5.0), ‘moderate’
([S]PASI > 5.0 - 12.0), or ‘severe’ ([S]PASI > 12.0). We divided the
sample into five patient groups based on the somatic course of the
(S)PASI in the 1-year follow-up: ‘improved’, ‘equally mild’, ‘equally
moderate’, ‘equally severe’, and ‘worse’. Results: Psoriasis patients
of the ‘improved’ and ‘equally mild’ groups showed a significant
increase on the scale ‘Search for Social Integration’ (p = 0.041 and
p = 0.005) and a significant decrease in the dimensions ‘Threat Minimization’
(p = 0.040 and p = 0.022) and ‘Search for Information and
Exchange of Experiences’ (p = 0.003 each) in the follow-up. However,
significantly higher values in the dimensions ‘Rumination’
(p = 0.029) and ‘Search for Support in Religion’ (p = 0.001) in the follow-
up were revealed for the patients of the ‘worse’ group. Conclusion:
The analysis firstly shows a clear empirically-based challenge
in which areas patients with ‘equally severe’ or ‘worse’ psoriasis
should be supported, i.e. the fields ‘Search for Social Integration’,
‘Threat Minimization’, and ‘Search for Information and Exchange of
Experiences’. In addition, results suggest that special psychological
or psychotherapeutic efforts are necessary to help this group to
develop an alternative behavior to the depression-associated
‘rumination’.