Does psychosocial stress play a role in the exacerbation of psoriasis?

Hunter, Hamish J.A.; Griffiths, C.E.M.; Kleyn, C. Elise

doi:10.1111/bjd.12478

Cited by 93 publications

(78 citation statements)

References 73 publications

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“…In psoriasis stress also has an impact on the skin peripheral HPA axis, and the SAM axis. However, the exact role and mechanism still need to be elucidated by further research due to conflicting data from different research groups [101]. …”

Section: Skin Neurogenic Inflammation During Stress Responsesmentioning

confidence: 99%

Brain-Skin Connection: Stress, Inflammation and Skin Aging

Chen

Lyga²

2014

IADT

184

161

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The intricate relationship between stress and skin conditions has been documented since ancient times. Recent clinical observations also link psychological stress to the onset or aggravation of multiple skin diseases. However, the exact underlying mechanisms have only been studied and partially revealed in the past 20 years or so. In this review, the authors will discuss the recent discoveries in the field of “Brain-Skin Connection”, summarizing findings from the overlapping fields of psychology, endocrinology, skin neurobiology, skin inflammation, immunology, and pharmacology.

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Section: Skin Neurogenic Inflammation During Stress Responsesmentioning

confidence: 99%

Brain-Skin Connection: Stress, Inflammation and Skin Aging

Chen

Lyga²

2014

IADT

184

161

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“…2 Whilst important in their own right, anxiety and depression may also prevent effective treatment. 3 Guidelines on management of long-term conditions, and specifically psoriasis, 4 recommend direct enquiry about the impact of psoriasis on well-being yet few clinicians work in this way as the acceptability and time taken for such holistic assessment may be problematic. has been shown to be acceptable to patients and staff.…”

Section: Introductionmentioning

confidence: 99%

Screening for anxiety and depression in people with psoriasis: a cross-sectional study in a tertiary referral setting

et al. 2016

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Summary Background National Institute for Health and Care Excellence guidance recommends assessment of psychological and social well‐being in people with psoriasis. Objectives To screen systematically for depression and anxiety in patients with psoriasis in routine clinical practice and to identify at‐risk groups for psychiatric morbidity. Methods Consecutive patients attending a single, tertiary centre over a 10‐month period were invited to complete the Patient Health Questionnaire Depression Scale (PHQ‐9), Generalized Anxiety Disorder Scale (GAD‐7) and Dermatology Life Quality Index (DLQI) as part of IMPARTS: Integrating Mental and Physical Healthcare: Research, Training and Services. Information on demographics, treatment and clinical disease severity was collated from electronic patient records. Regression models were used to identify at‐risk groups for psychiatric morbidity. Results Of 607 patients included (56·2% on biologics), 9·9% (95% confidence interval 7·5–12·3%) screened positive for major depressive disorder (MDD) and 13·1% (79/604) (95% confidence interval 10·4–15·8%) for generalized anxiety disorder (GAD; GAD‐7 score > 9). Suicidal ideation was reported in 35% of those with MDD; DLQI was < 10 in 38·3% and 45·6% cases of MDD and GAD, respectively. After adjusting for covariates, the risk of MDD or GAD was significantly higher in women and those with severe clinical disease, psoriatic arthritis and previous depression/anxiety. The risk of GAD was significantly increased with Asian ethnicity and use of topical treatments only. Conclusions Systematic screening for anxiety and depression identifies clinically important levels of depression and anxiety that may be missed using DLQI data alone. Women and those with severe disease, psoriatic arthritis and/or a prior history of psychiatric morbidity may be at particular risk.

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“…These findings may suggest that patients who do not recognize or pay attention to their bodily signals may be at risk for psychological problems. This may be relevant not only for patient wellbeing, but also for dermatological treatment outcomes, as it is known that psychological distress plays a significant role in the exacerbation of psoriasis (50). An alternative explanation could be that patients with high levels of psychological distress may be less aware of their bodily signals as they are focused on exaggerated worries of, for example, health anxiety.…”

Section: Discussionmentioning

confidence: 99%

Body Attention, Ignorance and Awareness Scale: Assessing Relevant Concepts for Physical and Psychological Functioning in Psoriasis

Beugen¹,

Ograczyk²,

Ferwerda³

et al. 2015

Acta Derm Venerol

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A certain level of attention to bodily signals may be adaptive in the management of chronic skin conditions, as a lack of attention may lead to inadequate self-care behaviour and, consequently, may affect functioning and treatment outcomes. The purpose of this study was to develop a body awareness questionnaire and to investigate its psychometric properties and physical and psychological correlates in a cross-sectional study in patients with psoriasis (n = 475). The 16-item Body Attention, Ignorance and Awareness Scale demonstrated a 3-factor structure that could be interpreted as body ignorance, body attention, and body awareness (Cronbach's α of 0.73, 0.74, and 0.68, respectively). Higher body ignorance was significantly related to more physical symptoms and worse psychological functioning. Body attention and body awareness showed small significant correlations with coping and personality. Given the negative influence of impaired psychological functioning on treatment outcomes, it may be clinically important to screen for theses constructs of body awareness in chronic skin conditions.

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Does psychosocial stress play a role in the exacerbation of psoriasis?

Cited by 93 publications

References 73 publications

Brain-Skin Connection: Stress, Inflammation and Skin Aging

Brain-Skin Connection: Stress, Inflammation and Skin Aging

Screening for anxiety and depression in people with psoriasis: a cross-sectional study in a tertiary referral setting

Body Attention, Ignorance and Awareness Scale: Assessing Relevant Concepts for Physical and Psychological Functioning in Psoriasis

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