Impact of Mental State on the Severity of Psoriasis Symptoms: A Study on Patient's Emotional Well-Being

Abstract

BACKGROUND Psoriasis is a chronic systemic skin disease affecting approximately 2% of the global population. In addition to the characteristic inflammatory changes on the skin, patients with psoriasis often experience comorbidities, including depressive symptoms and anxiety. This study aimed to investigate the relationship between the course of psoriasis and the mental state of patients. MATERIAL AND METHODS The study was conducted among 70 patients with psoriasis. An interview was conducted to assess the course of psoriasis. The Beck Depression Inventory (BDI) and Hospital Anxiety and Depression Scale (HADS) were used. CRP concentration as well as VAS, NRS, and PASI scales were measured. The results were subjected to statistical analysis. RESULTS Psoriasis was severe in 50% of the patients. Most (52.8%) of patients had moderate pruritis (VAS) and 58.5% had moderate pain (NRS). Moderate depressive symptoms (BDI) were present in 60% of patients, 18.6% had pathological anxiety (HADS-A), and 18.6% had pathological depression (HADS-D). CRP levels were significantly associated with PASI, VAS, and NRS. CONCLUSIONS The mental state of the patient plays an essential role in the course of psoriasis, and negative emotions affect the severity of skin symptoms. Emotional stress to patients with psoriasis should be limited, which will undoubtedly contribute to overall improvement of health.

Figure 1

BDI and pruritus severity. Among those in the “moderate” group of VAS variable, lower values of the BDI trait were observed compared to the “severe” group. All quartiles of the “moderate” group of the BDI variable are lower than the corresponding quartiles of the “severe” group.

Figure 2

BDI and pain severity. Those in the “moderate” group of NRS variable have higher average values of the BDI variable than those in the “severe” group. In addition, a larger interquartile range was observed in the “moderate” group, and the extreme outliers in the “severe” group are lower than the third quartile in the “moderate” group.

Figure 3

Gender and the course of psoriasis (A) and the emotional state of patients (B). The t test for independent samples. Due to the sample sizes being larger than 30 in the studied subgroups, the t test for paired samples was applied (without the Welch correction, as the Levene’s test did not show significant differences in variances). The t test did not reveal any significant differences between the groups defined by the gender variable.

Figure 4

Age and the course of psoriasis (A) and the emotional state of patients (B). The Spearman correlation tests did not show any significant relationships between the studied variables.