Only limited support for a role of psychosomatic factors in psoriasis. Results from a case-control study.
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.
Picardi
Angelo
A
Clinical Epidemiology Unit, Dermatological Institute IDI-IRCCS, Via dei Monti di Creta, 104-00167, Rome, Italy. a.picardi@idi.it
Pasquini
Paolo
P
Cattaruzza
Maria Sofia
MS
Gaetano
Paola
P
Baliva
Giannandrea
G
Melchi
Carmelo Franco
CF
Tiago
Albertina
A
Camaioni
Diana
D
Abeni
Damiano
D
Biondi
Massimo
M
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