The authors declare that they have no competing interests.
CR participated in the design of the study, met each patient and carried out the psychococial interviews, acquisition, analysis and interpretation of data, performed the statistical analysis and drafted the manuscript. KS participated in the design of the study, analysis and interpretation of data and have been involved in drafting the manuscript. ÅS participated in the design of the study, analysis and interpretation of data and have been involved in drafting the manuscript. All authors read and approved the final manuscript.
KS is a senior psychiatrist with many years of experience within the field of psychosomatics, both in clinical practice and research.
Stress or psychological distress is often described as a causative or maintaining factor in psoriasis. Psychological traits may influence the appraisal, interpretation and coping ability regarding stressful situations. Detailed investigations of psychological traits in relation to stress reactivity in psoriasis are rare. The aim of this study was to examine whether patients with psoriasis who report an association between psychological distress and exacerbation, “stress reactors” (SRs), differ psychologically from those with no stress reactivity “non-stress reactors” (NSRs).
This cross-sectional study was conducted among 101 consecutively recruited outpatients with plaque psoriasis. A psychosocial interview was performed including questions concerning stress reactivity in relation to onset and exacerbation. Three validated self-rating scales were used: Spielberger State-Trait Anxiety Inventory (STAI, Form-Y), Beck Depression Inventory (BDI-II) and Swedish Universities Scales of Personality (SSP). Independent samples t-tests, Chi-square tests and one-way ANOVA analyses were used for group comparisons when appropriate. A logistic regression model was designed with SR as the dependent variable.
Sixty-four patients (63%) reported a subjective association between disease exacerbation and stress (SRs). Patients defined as SRs reported significantly higher mean scores regarding state and trait anxiety, depression, and also five SSP scale personality traits, i.e. somatic trait anxiety, psychic trait anxiety, stress susceptibility, lack of assertiveness and mistrust, compared with NSRs. In multivariate analysis, SSP-stress susceptibility was the strongest explanatory variable for SR, i.e. OR (95% CI) = 1.13 (1.02 – 1.24), p = 0.018.
According to our results, patients who perceive stress as a causal factor in their psoriasis might have a more vulnerable psychological constitution. This finding suggests important opportunities for clinicians to identify patients who may benefit from additional psychological exploration and support.
Selye H. Stress without distress. New York: JB Lippincott; 1974.
Fortune D, Richards H, Main C, Griffiths C. Pathological worrying, illness perceptions and disease severity in patients with psoriasis. Br J Health Psychol. 2000;5:71–82. CrossRef
Spielberger C, editor. Manual for the state-trait anxiety inventory, STAI (form-Y). Palo Alto, CA: Consulting Psychologists Press Inc; 1983.
Beck A, Steer R. Garbin. Psychometric Properties of the Beck Depression Inventory, 2 nd edn. Manual. Swedish version. San Antonio, TX, U.S.A.: Psykologiförlaget AB under license from Harcourt Assessment Inc.; 1996.
Gustavsson J, Bergman H, Edman G, Ekselius L, von Knorring L, Linder JM. Swedish universities Scales of Personality (SSP) Manual. Version 2.1. Uppsala: Karolinska Institutet, Stockholm and Uppsala University; 2000.
Antonovsky H, Sagy S. The development of a sense of coherence and its impact on responses to stress situations. J Soc Psychol. 1986;126:213–25. PubMed
Kupfer J, Niemeier V, Brosig B, Pauli-Pott U, Karpinski G, Küster W, et al. Sense of coherence among psoriatics as a predictor of symptom-free time following dermatological inpatient therapy. Dermatol Psychosom. 2003;4:200–6. CrossRef
Rieder E, Tausk F. Psoriasis, a model of dermatologic psychosomatic disease: psychiatric implications and treatments. Int J Dermatol. 2012;5:12–26. CrossRef
- Subjective stress reactivity in psoriasis – a cross sectional study of associated psychological traits
- BioMed Central
Neu im Fachgebiet Dermatologie
Meistgelesene Bücher aus dem Fachgebiet
Mail Icon II