title: Only limited support for a role of psychosomatic factors in psoriasis. Results from a case-control study.
abstract: OBJECTIVE
  To investigate the role of stressful events, social support, attachment security and alexithymia in triggering or exacerbating psoriasis.
  
  
  METHODS
  Outpatients experiencing a recent onset or exacerbation of psoriasis (n=40) were compared with outpatients with skin conditions in which psychosomatic factors are regarded as negligible (n=116). Stressful events during the last year were assessed with Paykel's Interview for Recent Life Events. Attachment style, alexithymia and perceived social support were assessed with the ECR questionnaire, the TAS-20 and the MSPSS, respectively.
  
  
  RESULTS
  The mean number of recently experienced life events, or of undesirable, uncontrollable or major events was not different between psoriatic patients and controls. The only stress measure that showed a slight trend towards an association with psoriasis was having experienced four or more stressful events in the preceding year. There was a statistical trend towards an association between alexithymia and psoriasis, whereas there were no significant differences between patients with psoriasis and controls with respect to perceived social support and attachment security. Subgroup analysis suggested that the role of all psychosomatic factors studied might be more important in certain clinical types, such as guttate and diffuse plaque psoriasis.
  
  
  CONCLUSIONS
  Our findings provide only limited support for a role of psychosomatic factors in psoriasis. Future studies should investigate chronic and daily stressors in addition to major life events, include measures of stress appraisal and include specifically patients with a recent onset of disease.
authors.affiliation: Clinical Epidemiology Unit, Dermatological Institute IDI-IRCCS, Via dei Monti di Creta, 104-00167, Rome, Italy. a.picardi@idi.it
authors.forename: Angelo
authors.initials: A
authors.lastname: Picardi
authors.forename: Paolo
authors.initials: P
authors.lastname: Pasquini
authors.forename: Maria Sofia
authors.initials: MS
authors.lastname: Cattaruzza
authors.forename: Paola
authors.initials: P
authors.lastname: Gaetano
authors.forename: Giannandrea
authors.initials: G
authors.lastname: Baliva
authors.forename: Carmelo Franco
authors.initials: CF
authors.lastname: Melchi
authors.forename: Albertina
authors.initials: A
authors.lastname: Tiago
authors.forename: Diana
authors.initials: D
authors.lastname: Camaioni
authors.forename: Damiano
authors.initials: D
authors.lastname: Abeni
authors.forename: Massimo
authors.initials: M
authors.lastname: Biondi
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000150:complications; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000523:psychology*; D011602:Psychophysiologic Disorders / Q000523:psychology*; D012944:Social Support; D013315:Stress, Psychological