Relevance of Psychosomatic Factors in Psoriasis: A Case-control Study

Abstract

The aim of this study was to assess the role of stressful life events, lack of social support and attachment insecurity in triggering exacerbations of psoriasis. Outpatients experiencing exacerbation of psoriasis in the last 6 months (n = 110) were compared with outpatients affected by skin conditions in which psychosomatic factors are believed to play a minor role (n = 200). Stressful life events during the last 12 months were assessed with Paykel's Interview for Recent Life Events. Perceived social support and attachment relationship were assessed with the Multidimensional Scale of Perceived Social Support and Experiences in Close Relationships Scale, respectively. In comparison with controls the patients with psoriasis reported more stressful life events in the last year. The statistically significant difference was found only for the sum of the first 25 events (odds ratio (OR) 1.98; 95% confidence interval (CI) 1.37-2.87; p < 0.001). Also, patients with psoriasis were more likely to score higher on both anxiety (OR = 1.44; CI = 1.09-1.92; p = 0.011) and avoidance attachment scale (OR = 1.49; CI = 1.04-2.14; p = 0.030), and perceived less support from their social network than did the comparison subjects. The results of this study confirm the relevance of psychosocial factors in psoriasis.

Kvalitet života obolelih od psorijaze

“…Psihijatrijski poremećaji, kao što su depresija i pokušaji samoubistva, nisu retki među pacijentima sa psorijazom [19,20]. Dodatno, psorijaza ima značajne ekonomske posledice po društvo -direktne troškove lečenja i indirektne troškove smanjene produktivnosti zbog odsustvovanja obolelih sa posla [21].…”

Haut, Bindung, Partnerschaft bei Patienten mit Neurodermitis und Psoriasis

“…Tendenziell wird eine vermehrte Bindungsunsicherheit zwar beobachtet, der Einfluss von z. B. fehlender sozialer Unterstützung auf Exazerbationen wird jedoch als eher tendenziell beschrieben [8]. Auch der bei sicher gebundenen Patienten erwartete unterstützende Effekt der sozialen Unterstützung in der Bewäl-tigung der Erkrankung konnte nicht gezeigt werden [15].…”

Reliability of Self-Reported Attachment Style in Patients With Severe Psychopathology

“…Parent-child interactions and attachment security have been found to be correlated with a variety of developmental outcomes, such as emotional regulation, empathy, social competence, and self-reliance (Allen & Manning, 2007;Attili, 1989;Sroufe, 2005). Attachment insecurity was also found to be associated with increased risk of several physical illnesses (Janković et al, 2009;McWilliams & Bailey, 2010;Mrazek, Casey, & Anderson, 1987;Picardi, Mazzotti, et al, 2005;, and a variety of mental disorders including mood, anxiety, somatoform, and personality disorders (Bifulco, Moran, Ball, & Bernazzani, 2002;Conradi & de Jonge, 2009;Fossati et al, 2003;Marazziti et al, 2007;Myhr, Sookman, & Pinard, 2004;Noyes et al, 2003;Waller, Scheidt, & Hartmann, 2004). Furthermore, research has uncovered associations between attachment insecurity and altered autonomic and endocrine reactivity to stress (Ahnert, Gunnar, Lamb, & Barthel, 2004;Feeney & Kirkpatrick, 1996) and decreased cellular immune function (Picardi et al, 2007 In recent years, there has been increasing recognition of the significance of social cognitive, interpersonal, and affective factors in determining vulnerability and outcome in severe psychiatric disorders (Garety, Kuipers, Fowler, Freeman, & Bebbington, 2001).…”