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Review
. 2022 Mar 25:12:25-33.
doi: 10.2147/PTT.S328447. eCollection 2022.

Assessing and Improving Psychological Well-Being in Psoriasis: Considerations for the Clinician

Brittany Blackstone #  1 , Radhika Patel #  1 , Anthony Bewley  2
Affiliations
Review

Assessing and Improving Psychological Well-Being in Psoriasis: Considerations for the Clinician

Brittany Blackstone et al. Psoriasis (Auckl). .

Abstract

Psoriasis is a common chronic, systemic inflammatory disease, affecting approximately 2% of the population worldwide. Psoriasis is associated with profound psychosocial comorbidity with a burden that extends well beyond the physical signs and symptoms. Psychosocial comorbidities strongly associated with psoriasis include anxiety and depression, suicidal ideation, and substance misuse. There is a substantial unmet need for access to psychological support for people with skin disease in the UK. Recent reports found that while up to 98% of patients felt that their skin disease had affected their emotional or psychological well-being, only 18% sought help. This care gap is largely due to a lack of awareness about the limited available services alongside poor recognition, diagnosis, and triaging. Addressing psychosocial support needs starts with early identification, which can be complex and challenging. Once patients who need further support are identified, outcomes can be improved through prompt and effective treatment of inflammation, cognitive behavioural therapy, meditation and mindfulness-based therapy (including motivational interviewing), and to some extent psychotropic medication. Finally, resources for mental health support are notoriously limited, with dire consequences for patients. It is imperative that a proportion of the new funding promised for mental health services is bookmarked for dermatology patients and adequate provision of multidisciplinary psychodermatology teams to best serve the needs of this population. Ultimately, psoriasis is a complex condition with multifactorial psychological and biological drivers. Psoriasis is associated with high levels of distress, which is often under-recognized. Fully addressing this condition requires a holistic approach to the physical and psychosocial aspects to maximise adherence, efficacy, and optimise patient quality of life.

Keywords: chronic illness; dermatology; mental health; psychosocial impact; quality of life; stigmatization.

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Conflict of interest statement

Professor Anthony Bewley reports personal fees from AbbVie, Almirall, Eli Lilly, Galderma, Janssen, Leo Pharma, Novartis, Sanofi, and UCB, outside the submitted work. The authors report no other conflicts of interest in this work.

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