Depressive symptoms and insecure attachment predict disability and quality of life in psoriasis independently from disease severity

Abstract

Psoriasis is a multisystemic inflammatory disease with a significant burden in terms of disability and reduced quality of life. The interrelations between disease severity, psychological well-being, and disability and/or health-related quality of life (HRQOL) of psoriatic patients are not fully understood. The aim of the study was to assess the relative role of disease severity, depressive symptoms, and insecure attachment in predicting disability and HRQOL in 105 patients with psoriasis. Objective measures of disease severity included the Body Surface Area (BSA), the Psoriasis Area and Severity Index (PASI), and the Pain Visual Analog Scale (pain-VAS). The Sheehan Disability Scale (SDS). The Dermatology Life Quality Index (DLQI). Multivariate hierarchical regression analysis showed that a preoccupied style of attachment and the presence of depressive symptoms were predictors of disability and HRQOL over and above the contribution of demographic and clinical variables. The inclusion of attachment and depression into multivariate regression models improved substantially the prediction of disability and HRQOL. Conversely, the predictive utility of objective indicators of disease severity was scarce and only the pain-VAS emerged as a significant predictor of disability whereas there were no significant correlations between HRQOL and any of the objective indicators of disease severity. Measures capturing patients’ perspectives of the functional impact of disease should be routinely included in the clinical assessment of psoriasis.

Nail and enthesis assessment in patients with psoriatic disease by high frequency ultrasonography: findings from a single-centre cross-sectional study

“…In last years, the concept of psoriatic disease has been developed thanks to a better understanding of molecular pathogenetic mechanisms leading to psoriasis (PSO) and associated musculoskeletal manifestations [ 1 ]. PSO is a common chronic skin inflammatory condition associated with quality-of-life impairment and disability [ 2 , 3 ]. The disease presents cutaneous manifestation as erythematous and scaling plaques with prototypical distribution in plaque-type PSO, but also rarer and severe variants, such as pustular and erythrodermic PSO and special localization such as nails, genitals, skin folds, and palmo-plantar areas [ 4 , 5 ].…”

Pszichodermatológia és egészségpszichológiai ellátás a bőrgyógyászatban

“…Különböző tanulmányokban vizsgálták bizonyos bőrbetegségeknél a bőrgyógyászati életminőség szintje és a kötődési jellemzők közötti kapcsolatokat. Az életminőség alacsony szintjével kapcsolódtak össze egyes bizonytalan kötődési stílusok jegyei pikkelysömörös (Esposito et al, 2020), krónikus csalánkiütéses (Barbosa et al, 2011) és atópiás dermatitiszes (Dieris-Hirche et al, 2012) pácienseknél. c) Megküzdés a bőrbetegséggel.…”

Impact of Attachment Style and Temperament Traits on the Quality of Life of Patients with Psoriasis

“…In the study by Esposito [ 34 ], the attachment style was studied in 105 patients with psoriasis, and it was found that the worried (anxious) attachment style is a predictor of a higher level of disability and worse quality of life. In these psoriatic patients, a therapeutic intervention targeting dysfunctional attachment may be useful.…”