Psychological Profile of Patients with Psoriasis

Abstract

Introduction: Psoriasis is a chronic inflammatory disease with a global prevalence of approximately 2% and significant psychiatric comorbidity. There is a great deal of existing literature assessing different aspects of psychology in psoriasis. We aimed to conduct an in-depth review of current evidence linking psoriasis to personality traits and psychiatric comorbidities, as well as factors that put these patients at risk of psychopathology. Materials and Methods: A search of the PubMed database identified 1632 articles. We included articles studying psychological comorbidity in patients with psoriasis, looking especially at personality characteristics, and data linking psoriasis with increased risks of psychological distress, depression, anxiety and suicidality. In particular, we also evaluated subgroups in psoriasis found to be at risk. Results: Patients with psoriasis are more likely to be alexithymic, lack body awareness and possess a Type D personality. Alcohol, but not illicit drug use, disorders are also more common in patients with psoriasis. Patient groups who are especially at risk of psychological distress include women, younger patients, patients with a younger age of disease onset, those who self-assess their psoriasis to be severe, and those with lesions on visible or sensitive areas. Adopting motivational interviewing skills and incorporating the use of learning materials during consultations have been found to be useful. Conclusion: The knowledge of personality characteristics, “at-risk” groups, and early recognition of psychological distress among patients with psoriasis can help clinicians provide better holistic care and encourage a change in patients’ behaviour. Key words: Alexithymia, Personality, Psychopathology, Suicidality

Epidemiology of Psoriasis and Comorbid Diseases: A Narrative Review

“…Risk factors of distress include female gender, a younger age of disease onset, those with self-assessment of severe psoriasis (68), type D personality (69), younger patients, and those with lesions on sensitive or visible areas (70). Alcohol disorders, not illicit drug use, are more common in patients with psoriasis (68).…”

A randomized controlled feasibility trial of online compassion‐focused self‐help for psoriasis*

“…Future research should aim to recruit a larger and more heterogeneous group coming from dermatology clinics, who present with more medical and psychosocial challenges. 35,36 Further, while current research supports the use of subjective disease severity ratings, as it has been found to be closely correlated with measures of distress, 37 the lack of an objective measure of psoriasis severity remains problematic and should be addressed in future studies. Additionally, information on age of onset, pruritus intensity, use of illegal substances or current treatment was not collected, and recording these types of data should be included in future studies.…”

“…In the same vein, some of the patients were taking antidepressant medication, which might have affected the study findings, and also the overall sample size could be characterized as small for such a large community of patients with psoriasis. Future research should aim to recruit a larger and more heterogeneous group coming from dermatology clinics, who present with more medical and psychosocial challenges 35,36 . Further, while current research supports the use of subjective disease severity ratings, as it has been found to be closely correlated with measures of distress, 37 the lack of an objective measure of psoriasis severity remains problematic and should be addressed in future studies.…”

Sexual Dysfunction in Women and Men with Psoriasis: A Cross-Sectional Questionnaire-Based Study

“…The location of psoriatic lesions was a clinically significant determinant of the level of stigma, and patients with visible lesions scored significantly higher on the Feelings of Stigmatization Questionnaire than those with invisible ones [ 10 ]. It has been suggested that emotional problems, depression and a higher suicide risk are associated with perceptions of higher psoriasis severity [ 22 ]. Interestingly, feeling stigmatized was the most influential predictor of depressive symptoms for psoriatic patients and accounted for 33% of the variance [ 20 ].…”