Psychological distress (PD) is common in patients with psoriasis but little is known about its evolution. The aim of this study is to assess the evolution of PD in psoriasis. For this purpose, 1,505 psoriatic patients, who had been previously enrolled in the PSYCHAE study, an observational multicenter Italian study, were re-evaluated after 6 and 12 months. Minor and major PD were assessed using the General Health Questionnaire (GHQ) and Brief Symptoms Inventory (BSI) questionnaires and coping using Brief COPE questionnaire. Minor PD was present in 46% of patients but halved during the study. Female gender, surface area, topical steroids, methotrexate, self-distraction, venting and behavioral disengagement were risk factors for minor PD; cyclosporine and humor were protective. Major PD was present in 11% of patients and remained stable. Female gender, venting, religion, behavioral disengagement and emotional support were risk factors for major PD; instrumental support was protective. In conclusion, the results obtained suggest that major PD remained stable after 12 months and that coping was a predictor of its evolution.
RussoPAIlchefRCooperAJ. Psychiatric morbidity in psoriasis: a review. Australas J Dermatol2004; 45:155–9.
2.
KirbyBRichardsHLWooPHindleEMainCJGriffithsCE. Physical and psychologic measures are necessary to assess overall psoriasis severity. J Am Acad Dermatol2001; 45:72–6.
3.
GriffithsCERichardsHL. Psychological influences in psoriasis. Clin Exp Dermatol2001; 26:338–42.
4.
O'LearyCJCreamerDHigginsEWeinmanJ. Perceived stress, stress attributions and psychological distress in psoriasis. J Psychosom Res2004; 57:465–71.
5.
ZachariaeRZachariaeHBlomqvistKDavidssonSMolinLMørkCSigurgeirssonB. Self-reported stress reactivity and psoriasis-related stress of Nordic psoriasis sufferers. J Eur Acad Dermatol Venereol2004; 18:27–36.
6.
FortuneDGRichardsHLKirbyBMcElhoneKMarkhamTRogersSMainCJGriffithsCE. Psychological distress impairs clearance of psoriasis in patients treated with photochemotherapy. Arch Dermatol2003; 139:752–6.
7.
GuptaMAGuptaAK. Psychiatric and psychological co-morbidity in patients with dermatologic disorders: epidemiology and management. Am J Clin Dermatol2003; 4:833–42.
8.
KulkarniASBalkrishnanRCamachoFTAndersonRTFeldmanSR. Medication and health care service utilization related to depressive symptoms in older adults with psoriasis. J Drugs Dermatol2004; 3:661–6.
9.
ScharlooMKapteinAAWeinmanJBergmanWVermeerBJRooijmansHG. Patients' illness perceptions and coping as predictors of functional status in psoriasis: a 1-year follow-up. Br J Dermatol2000; 142:899–907.
10.
FortuneDGRichardsHLKirbyBMcElhoneKMainCJGriffithsCE. Successful treatment of psoriasis improves psoriasis-specific but not more general aspects of patients' well-being. Br J Dermatol2004; 151:1219–26.
11.
FinziAColomboDCaputoAAndreassiLChimentiSVenaGSimoniLSgarbiSGiannettiA: PSYCHAE Study Group. Psychological distress and coping strategies in patients with psoriasis: the PSYCHAE Study. J Eur Acad Dermatol Venereol2007; 21:1161–9.
12.
ColangeloPMWelchDWRichDSJeffreyLP. Two methods for estimating body surface area in adult amputees. Am J Hosp Pharm1984; 41:2650–5.
13.
BellantuonoCFiorioRZanotelliRTansellaM. Psychiatric screening in general practice in Italy. A validity study of the GHQ (General Health Questionnaire). Soc Psychiatry1987; 22:113–7.
14.
PiccinelliMBisoffiGBonMGCunicoLTansellaM. Validity and test-retest reliability of the Italian version of the 12-item General Health Questionnaire in general practice: a comparison between three scoring methods. Compr Psychiatry1993; 34:198–205.
15.
DerogatisLRMelisaratosN. The Brief Symptom Inventory: an introductory report. Psychol Med1983; 13:595–605.
16.
CarverCS. You want to measure coping but your protocol's too long: consider the brief COPE. Int J Behav Med1997; 4:92–100.
MenterAGriffithsCE. Current and future management of psoriasis. Lancet2007; 370:272–84.
19.
GriffithsCEDubertretLEllisCN. Ciclosporin in psoriasis clinical practice: an international consensus statement. Br J Dermatol2004; 150(S):11–23.
20.
GriffithsCEKatsambasADijkmansBAFinlayAYHoVCJohnstonALugerTAMrowietzUThestrup-PedersenK. Update on the use of ciclosporin in immune-mediated dermatoses. Br J Dermatol2006; 155 (S):1–16.
21.
KruegerGKooJLebwohlMMenterASternRSRolstadT. The impact of psoriasis on quality of life: results of a 1998 National Psoriasis Foundation patient-membership survey. Arch Dermatol2001; 137:280–4.
22.
SchmittJFordDE. Understanding the relationship between objective disease severity, psoriatic symptoms, illness-related stress, health-related quality of life and depressive symptoms in patients with psoriasis - a structural equations modeling approach. Gen Hosp Psychiatry2007; 29:134–40.
23.
SampognaFTabolliSMastroeniSDi PietroCFortesCAbeniD: Italian Multipurpose Psoriasis Research on Vital Experiences (IMPROVE) study group Quality of life impairment and psychological distress in elderly patients with psoriasis. Dermatology2007; 215:341–7.
24.
EghlilebAMDaviesEEFinlayAY. Psoriasis has a major secondary impact on the lives of family members and partners. Br J Dermatol2007; 156:1245–50.
25.
ZalewskaAMiniszewskaJChodkiewiczJNarbuttJ. Acceptance of chronic illness in psoriasis vulgaris patients. J Eur Acad Dermatol Venereol2007; 21:235–42.
26.
RappSRCottrellCALearyMR. Social coping strategies associated with quality of life decrements among psoriasis patients. Br J Dermatol2001; 145:610–6.
27.
ConsoliSMRolhionSMartinCRuelKCambazardFPelletJMiseryL. Low levels of emotional awareness predict a better response to dermatological treatment in patients with psoriasis. Dermatology2006; 212:128–36.
28.
KeinanGSegalAGalUBrennerS. Stress management for psoriasis patients: the effectiveness of biofeedback and relaxation techniques. Stress Medicine1994:235–41.
29.
FortuneDGRichardsHLKirbyBBowcockSMainCJGriffithsCE. A cognitive-behavioural symptom management programme as an adjunct in psoriasis therapy. Br J Dermatol2002; 146:458–65.
30.
TauskFWhitmoreSE. A pilot study of hypnosis in the treatment of patients with psoriasis. Psychother Psychosom1999; 68:221–5.
31.
VedharaKMorrisRMBoothRHorganMLawrenceMBirchallN. Changes in mood predict disease activity and quality of life in patients with psoriasis following emotional disclosure. J Psychosom Res2007; 62:611–9.
