Childhood trauma: a risk for major depression in patients with psoriasis

Abstract

INTRODUCTION:A history of childhood trauma is an important determinant for understanding the development of psychiatric and physical disorders. The chronic inflammatory disease, psoriasis, has been reported to be affected by childhood psychological stressors. Early life stress is also a well-known contributor to major depression. The current study aims to clarify a possible association between levels and types of childhood trauma with psoriasis severity and major depression. METHOD: Sixty-four patients diagnosed with mild-to-severe psoriasis (male = 27, mean age = 52.51 ± 14.72 years and female = 37, mean age = 42.76 ± 14.45 years, age range = 21-77) were admitted to our study between April 2014 and September 2014. For the diagnosis of psoriasis, the single most recently developed lesion was examined dermoscopically and histopathologically. We evaluated the history of childhood trauma with the Childhood Trauma Questionnaire and diagnosis of major depression with the Mini International Neuropsychiatric Interview (MINI 5.0.0 current). The participants were scanned for their severity of psoriasis with Psoriasis Area and Severity Index 75 (PASI 75). Initially, the data were checked for normality using Kolmogorov-Smirnov/Shapiro-Wilk's tests, histograms, and probability plots. Because normality of the data could not be assumed, we evaluated childhood trauma subscales and psoriasis by running Kendell's tau-b correlation coefficients for bivariate comparisons. Mann-Whitney U test was conducted to assess the differences in childhood trauma severity of each subscale between two groups of depressed and nondepressed patients with psoriasis. Ultimately, we ran chi-square analysis to evaluate the association between gender and depression. RESULTS: Emotional (0.325), physical (0.614), sexual (0.963) abuse, and emotional (0.331) neglect were positively correlated with higher severity of psoriasis (p < .01). Subsequently, emotional (U = 372, p = .43), physical (U = 387, p = .049), sexual (U = 297, p = .0005) abuse, emotional (U = 299.5, p = .001), and physical U = 372, p = .031) neglect were significantly higher in psoriasis patients with depression compared to non-depressed (p < .05). CONCLUSION:The findings of the current study underline the relationship between childhood trauma and major depression, as well as childhood trauma and psoriasis. The increased level of emotional, physical, sexual abuse, and emotional neglect was linked to elevated severity of psoriasis. Likewise, all childhood trauma subtypes appeared to be more severe in the group of psoriasis patients with major depression. Investigation of childhood traumatic experiences, and major depression in individuals with psoriasis, the screening of depressed patients for psoriasis, and the cross-referencing of the outcome can be expected to provide remarkable findings, new approaches for diagnosis and treatment, as well as implications for promulgating new legislation.

Childhood Trauma and Psychosocial Stress Affect Treatment Outcome in Patients With Psoriasis Starting a New Treatment Episode

“…This is in line with existing evidence confirming a relationship between retrospectively reported childhood experiences and psoriasis ( 14 – 16 , 54 ). The severity of psoriasis was not correlated with traumatic experiences which is in line with Simonic et al ( 14 ) but contradicts other findings ( 55 ). The latter study also applied the CTQ and could show lower values than in our present sample (especially on the subscale sexual abuse).…”

“…The latter study also applied the CTQ and could show lower values than in our present sample (especially on the subscale sexual abuse). The differences may be explained by peculiarities in the patient sample ( 55 ). The above mentioned study excluded PSO with a history of any psychiatric disorders and only patients from an outpatient clinic were enrolled.…”

Audiological and Other Factors Predicting the Presence of Misophonia Symptoms Among a Clinical Population Seeking Help for Tinnitus and/or Hyperacusis

“…This is consistent with reports of a higher impact of tinnitus, hyperacusis-induced anxiety, and depression symptoms among patients who reported that during their first 18 years of life their parent(s) suffered from a mental illness ( Aazh et al, 2018 , 2019a , c , 2020 ). Mounting evidence suggests that adverse childhood experiences play a major lifelong role in mental and physical problems ( Anda et al, 2006 , 2010 ; Erfanian, 2018 ). Parental mental illness is an important form of adverse childhood experiences ( Anda et al, 2006 ).…”

Understanding the experiences of anger in the onset and progression of psoriasis: A thematic analysis

“…For some, this sense of underachieving resulted from a disruption to psychosexual maturation in adolescence lasting into early adulthood with negative beliefs about self/desirability being maintained in later life. 19,20 The complexities of backgrounds influenced anger, with the trauma reported in this study being similarly found in psoriasis 7,10,11 and other autoimmune conditions. 47 Participants perceived that anger caused by trauma had negatively impacted their health and contributed to both the onset and progression of psoriasis, suggesting that the challenges of living with psoriasis could serve as a secondary trauma.…”

“…Although psoriasis is an autoimmune condition, it is multifactorial in expression 3,4 as emotional life events can influence onset and clinical course. Research has focussed on the role of emotions 5,6 and stressful or traumatic life events triggering psoriasis 7–9 ; however, studies have reported mixed findings 10–12 . As such, questions remain about the role of emotions and experiences, their relationship with symptom severity, and the mechanisms of which trauma may interact with inflammatory markers 13 .…”