Stressful Life Events and Psoriasis during the War in Bosnia

Suljagic, Edin; Sinanović, Osman; Tupković, Emir; Moro, Lj.

doi:10.1159/000017506

Cited by 11 publications

(13 citation statements)

References 10 publications

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“…Our results are in agreement with a recent study by Simoniç et al [2000] who demonstrated presence of psychic stress in 69% of psoriatic patients. Only few studies have focused on the relationship between intensity of stress and severity of psoriasis [Gaston et al, 1991;Harvima et al, 1996;Suljagic et al, 2000]. Although we were unable to find a direct positive correlation between intensity of preceding stress and severity of the disease, patients who did experience stressful life events suffered from significantly more severe psoriasis (higher PASI scores).…”

Section: Discussioncontrasting

confidence: 63%

Stressful Life Events and Depression in Patients Suffering from Psoriasis Vulgaris

Pacan¹,

Szepietowski²,

Kiejna³

2003

Dermatol Psychosom

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Background: Psoriasis is a chronic inflammatory skin disease. Its pathogenesis is not completely clear; there are some suggestions that psychological factors may play an important pathogenic role. Objective: To evaluate the influence of stressful life events on exacerbation of psoriasis and comorbidity of depression. Patients and Methods: 77 psoriatic individuals, aged 18–78 years, were included in the study. Stress was assessed according to the Social Readjustment Rating Scale by Holmes and Rahe. All patients underwent psychiatric examination for depression (according to ICD-10). Intensity of depression was evaluated by Hamilton and Beck scales. Results: 61% of psoriatic patients reported having experienced stressful life events in the month before exacerbation of the disease. Severity of psoriasis (Psoriasis Area and Severity Index, PASI) in patients with stressful life events (22.8 ±9.3 points) was significantly higher (p < 0.0001) compared to those without stress (14.0 ±9.2 points). There was no correlation between intensity of stress and severity of psoriasis. Depression was diagnosed in 16.9% of the patients. Psoriatic individuals suffering from depression were significantly younger (p < 0.05). No significant relationship was found between intensity of depression and the PASI score, nor between intensity of stress and severity of depression. Conclusions: More than half of the psoriatic patients studied had experienced at least one stressful life event in the month before psoriasis exacerbation. Moreover, the severity of psoriasis is significantly increased in patients with preceding stressful life events. Depression could be diagnosed in less than 20% of psoriatic patients, the majority of them suffering from reactive disorders.

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Section: Discussioncontrasting

confidence: 63%

Stressful Life Events and Depression in Patients Suffering from Psoriasis Vulgaris

Pacan¹,

Szepietowski²,

Kiejna³

2003

Dermatol Psychosom

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“…Many studies have investigated possible links between the stress and the onset and exacerbation of psoriasis [1,2,3,4,5,6,7,8,9]. Stress appears to be the most powerful inducer of psoriatic rashes [2,3,4,5, 7, 9, 10].…”

Section: Introductionmentioning

confidence: 99%

Low Levels of Emotional Awareness Predict a Better Response to Dermatological Treatment in Patients with Psoriasis

et al. 2006

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Background: Personality and emotional factors are thought to influence the onset of psoriasis, the occurrence of relapses, and the sensitivity of this condition to dermatological treatments. Objective:To explore the relationships between emotional disorders and emotional information processing in the one hand, and psoriasis severity and response to treatment on the other. Methods: We recruited 93 patients through an article in the local press. These patients attended three consultations. We evaluated psoriasis severity by Psoriasis Area and Severity Index (PASI) score and response to treatment by change in PASI score from baseline to the 3-month visit. We screened for comorbid mental disorders, using the Mini International Neuropsychiatric Interview. We used the Hospital Anxiety and Depression Scale to assess anxiety and depressive symptoms. Alexithymia (difficulty in identifying and expressing emotions) was evaluated with the 26-item version of the Toronto Alexithymia Scale (TAS-26) and the ability to integrate and differentiate emotions (emotional awareness) was assessed with the Lane and Schwartz Levels of Emotional Awareness Scale (LEAS). Results: Forty patients presented at least one psychiatric diagnosis and 33 were considered alexithymic (TAS ≧73). No psychological score was associated with baseline PASI score, which was higher in men and positively correlated with disease duration. Patients who considered their disease to be stress-reactive tended to have lower LEAS scores (p = 0.052). At the 3-month visit, PASI scores had significantly improved in the subset of patients (n = 67) presenting severe psoriasis at inclusion (PASI >2); emotional awareness and anxiety scores had also improved in these patients (p < 0.001), but dermatological and psychological changes were not statistically related. Dermatological improvement at 3 months with respect to baseline PASI was predicted by longer disease duration (>20 years) and lower baseline LEAS score (p = 0.044 and p = 0.021, respectively). Conclusion: This study demonstrates the value of assessing the ability of patients with psoriasis to process emotional information, as defined by emotional awareness. Patients with low LEAS scores appear to be more reactive to stress, but also to be more responsive to treatment, suggesting the activation of a particular stress physiology by negative affective states that are not experienced.

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“…Various studies have investigated the correlation between emotional stress and psoriasis [Baughman and Sobel, 1971;Gaston et al, 1987;Gupta et al, 1989;Harvima et al, 1996;Suljagic et al, 2000]. It is necessary to distinguish between stressors due to daily hassles and life events, and stress due to the illness itself.…”

Section: Introductionmentioning

confidence: 99%

Sense of Coherence among Psoriatics as a Predictor of Symptom-Free Time Following Dermatological Inpatient Therapy

Kupfer¹,

Niemeier²,

Brosig³

et al. 2003

Dermatol Psychosom

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Objective: In the present study, we investigated the health-protective resources of psoriatics, operationalized via their sense of coherence. Our objective was to determine whether the strength of these resources has an influence on the duration until relapse. Patients and Methods: 72 patients were examined three times (before, immediately after, and 15–18 months after treatment). Along with the Psoriasis Area Severity Index score and determination of the subjective estimation of severity, patients were asked to answer questionnaires relating to how they were dealing with their illness as well as to lifequality, sense of coherence (SOC), and critical life events. Results: Personal estimation of severity of condition and PASI values at the commencement of therapy highly correlated. At follow-up after balneophototherapy, subjective severity of condition had almost returned to the initial value. 76.7% of the patients experienced relapse within the first 6 months following therapy. The level of the score for manageability correlates with the length of time until the first relapse. Patients with low SOC suffered their first relapse 3.5 months after therapy, while patients with high SOC underwent first relapse after 10 months on average. Conclusion: The data suggest that the SOC could play a protective role in respect of the tendency towards relapse among psoriatics.

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Stressful Life Events and Psoriasis during the War in Bosnia

Cited by 11 publications

References 10 publications

Stressful Life Events and Depression in Patients Suffering from Psoriasis Vulgaris

Stressful Life Events and Depression in Patients Suffering from Psoriasis Vulgaris

Low Levels of Emotional Awareness Predict a Better Response to Dermatological Treatment in Patients with Psoriasis

Sense of Coherence among Psoriatics as a Predictor of Symptom-Free Time Following Dermatological Inpatient Therapy

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