title: Distribution pattern of psoriasis, anxiety and depression as possible causes of sexual dysfunction in patients with moderate to severe psoriasis.
abstract: BACKGROUND
  Psoriasis may significantly impair sexual function. Depression and organic factors appear to play a key role in this relation. However, beyond genital psoriasis, the importance of the disease's distribution patterns has not been considered.
  
  
  OBJECTIVE
  To research sexual function in psoriasis patients and investigate the roles of anxiety, depression and psoriasis' distribution patterns in sexual dysfunction.
  
  
  METHODS
  A comparative study matched for sex and age was performed. Eighty patients with moderate to severe psoriasis and 80 healthy controls were included. The participants completed the Massachusetts General Hospital-Sexual Functioning Questionnaire, the Hospital Anxiety and Depression Scale, and the Self-Administered Psoriasis Area and Severity Index.
  
  
  RESULTS
  Psoriasis was associated with sexual dysfunction, odds ratio=5.5 (CI 95% 2.6-11.3; p<0.001). Certain distribution patterns of psoriasis, involving specific body regions, were associated with an increase in sexual dysfunction in the group presenting the disease, odds ratio 7.9 (CI 95% 2.3-33.4; p<0.001). Multivariate logistic regression analysis identified anxiety and depression, and the involvement of these specific areas, as possible independent risk factors for sexual dysfunction in patients with moderate to severe psoriasis.
  
  
  CONCLUSIONS
  This study identifies body areas potentially related to sexual dysfunction, independently of anxiety and depression, in psoriasis patients. The results suggest that the assessment of sexual dysfunction and the involvement of these body areas should be considered as disease severity criteria when choosing the treatment for psoriasis patients.
authors.affiliation: Granada University Hospital, University of Granada, Granada, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Molina-Leyva
authors.affiliation: Granada University Hospital, University of Granada, Granada, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Almodovar-Real
authors.affiliation: Granada University Hospital, University of Granada, Granada, Spain.
authors.forename: Jose Carlos-Ruiz
authors.initials: JC
authors.lastname: Carrascosa
authors.affiliation: Granada University Hospital, University of Granada, Granada, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Molina-Leyva
authors.affiliation: Granada University Hospital, University of Granada, Granada, Spain.
authors.forename: Ramon
authors.initials: R
authors.lastname: Naranjo-Sintes
authors.affiliation: CIBER de Epidemiología y Salud Pública, Spain.
authors.forename: Jose Juan
authors.initials: JJ
authors.lastname: Jimenez-Moleon
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001828:Body Image / Q000523:psychology; D016022:Case-Control Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000523:psychology*; D012720:Severity of Illness Index; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology / Q000523:psychology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013732:Test Anxiety Scale