title: The psychophysiological stress response in psoriasis and rheumatoid arthritis.
abstract: BACKGROUND
  Psychosocial stress can be a risk factor for the maintenance and exacerbation of chronic inflammatory diseases, such as psoriasis and rheumatoid arthritis (RA).
  
  
  OBJECTIVE
  To gain insight into the specificity of the psychophysiological stress response during chronic inflammation, we assessed autonomic and neuroendocrine responses to stress in different chronic inflammatory diseases.
  
  
  METHODS
  Thirty patients with psoriasis (nine women, mean age 58·5 years ± 12·4), 34 patients with RA (16 women, mean age 60·8 years ± 9·2) and 25 healthy controls (16 women, mean age 55·6 years ± 8·7) underwent a standardized psychosocial stress task (Trier Social Stress Test). Salivary levels of α-amylase and cortisol and self-reported tension levels were measured before and after the stress test.
  
  
  RESULTS
  The cortisol response to stress was heightened in patients with psoriasis compared with patients with RA and healthy controls, whereas there were no differences in the autonomic and self-reported measures.
  
  
  CONCLUSIONS
  The altered neuroendocrine stress response in patients with psoriasis suggests that stressful events might have different physiological consequences for specific patient groups with chronic inflammatory conditions, possibly adversely affecting disease status.
authors.affiliation: Department of Medical Psychology, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands; Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, P.O. Box 9555, 2300 RB, Leiden, the Netherlands.
authors.forename: S J M
authors.initials: SJ
authors.lastname: de Brouwer
authors.forename: H
authors.initials: H
authors.lastname: van Middendorp
authors.forename: C
authors.initials: C
authors.lastname: Stormink
authors.forename: F W
authors.initials: FW
authors.lastname: Kraaimaat
authors.forename: F C G J
authors.initials: FC
authors.lastname: Sweep
authors.forename: E M G J
authors.initials: EM
authors.lastname: de Jong
authors.forename: J
authors.initials: J
authors.lastname: Schalkwijk
authors.forename: A
authors.initials: A
authors.lastname: Eijsbouts
authors.forename: A R T
authors.initials: AR
authors.lastname: Donders
authors.forename: P C M
authors.initials: PC
authors.lastname: van de Kerkhof
authors.forename: P L C M
authors.initials: PL
authors.lastname: van Riel
authors.forename: A W M
authors.initials: AW
authors.lastname: Evers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000523:psychology*; D016022:Case-Control Studies; D003879:Dermatologic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy / Q000523:psychology*; D012307:Risk Factors; D012463:Saliva / Q000737:chemistry; D013315:Stress, Psychological / Q000150:complications*; D000516:alpha-Amylases / Q000378:metabolism
chemical_list: D018501:Antirheumatic Agents; D003879:Dermatologic Agents; D000516:alpha-Amylases; D006854:Hydrocortisone