Effect of Daily Stressors on Psoriasis: A Prospective Study

Verhoeven, E.W.M.; Kraaimaat, Floris W.; Jong, E.M.G.J. de; Schalkwijk, Joost; Kerkhof, P.C.M. van de; Evers, Andrea W. M.

doi:10.1038/jid.2008.460

Cited by 62 publications

(78 citation statements)

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“…In particular the unpredictable course of a skin condition and the lack of control can make coping more difficult. In line with research on other chronic physical conditions there is some indication that a more passive, avoiding coping style and catastrophizing cognitions can negatively affect the course of a condition and the success of a treatment [7,8,25,28]. Furthermore, studies in people with atopic eczema and psoriasis have revealed connections between perceived helplessness in coping with the condition and decreased physical and psychological well-being [2].…”

Section: R D I S T R I B U T I O Nmentioning

confidence: 69%

“…Accordingly, in patients with atopic eczema, subjective stress proved to predict disease severity on the following day [26]. Additionally, in patients with psoriasis, high levels of daily stressors were associated with an increase in disease severity and itch four weeks later [24,25]. Stressors can influence wound healing [27], although this relationship has not been studied in patients with skin conditions.…”

Section: Psychosocial Factors In Dermatological Conditionsmentioning

confidence: 99%

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Psychological Treatments for Dermatological Conditions

2016

Skin and Psyche

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Abstract:The impact of dermatological conditions on a patient's life is frequently underestimated. Patients with skin conditions experience several physical complaints, including itch, pain and fatigue. Furthermore, in comparison to the general population, patients report a decreased psychological well-being, lowered quality of life and feelings of stigmatization and shame. Psychological treatments are widely used in addition to regular dermatological treatments to improve physical and psychological functioning of patients with chronic skin conditions. These treatments are usually aimed at changing the psychosocial factors that can influence the onset and/or course of skin conditions, such as dysfunctional coping behaviors, itch-scratching problems and stress. There are unimodal interventions in which single treatments are used, for example psychoeducation or relaxation exercises, and multimodal treatments in which a variety of different interventions are applied based on cognitive-behavioral therapy and self-management principles. Furthermore, a distinction can be made between interventions that focus primarily on skin-related psychosocial problems, interventions that focus on itch-scratching problems, and interventions that are focused on psychiatric problems in the dermatological practice. This chapter gives an overview on the psychosocial factors relevant for dermatological conditions, relevant diagnostic methods and the content and scientific evidence of specific psychological treatments in these different categories.

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Section: R D I S T R I B U T I O Nmentioning

confidence: 69%

Section: Psychosocial Factors In Dermatological Conditionsmentioning

confidence: 99%

Psychological Treatments for Dermatological Conditions

2016

Skin and Psyche

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“…A bevezetőben említett, a betegségüket saját bevallásuk szerint stresszérzékenynek, illetve a nem stresszérzékenynek tartó pikkelysömörös betegek közöt-ti klinikai különbségek ismeretében érdekes megvizsgál-ni, hogy a két csoport közötti különbség a hormonok szintjén is megjelenik-e. Richards és mtsai azt találták, hogy a betegségüket stresszérzékenynek vallók stresszor előtti bazális kortizolszintjei alacsonyabbak voltak, és a stresszre is csökkent kortizoltermeléssel reagáltak [56]. Verhoeven és mtsai pedig azt a megfi gyelést tették vizsgá-latukban, amely az egyetlen, eddig a témában elkészült prospektív tanulmány, hogy az egy hónappal korábban magasabb stressz-szintről beszámoló betegek tünetei sú-lyosabbak, kortizolszintjük pedig alacsonyabb volt a következő vizit alkalmával [10]. Ez felveti, hogy a pikkelysömörös betegekben megfi gyelt pszichológiai kü-lönbségek hormonális eltérésekben is manifesztálódnak: alacsonyabb kortizolválasszal reagálnak egy-egy streszszorra, ami hajlamosíthatja őket a tüneteik stressz hatá-sára bekövetkező fellángolására.…”

Section: A Hypothalamo-hypophyseo-adrenalis éS a Sympathyco-adrenomedunclassified

“…Fontos azonban megjegyezni, hogy más szerzők nem találtak kapcsolatot az életesemények és a tünetek súlyos-sága között, és eddig sem az ok-okozati kapcsolatot, sem a folyamat hátterében álló pontos patomechanizmust nem sikerült egyértelműen bizonyítani [10,11]. Ezt részben magyarázhatja, hogy sok vizsgálat redukcionista: vagy csak a biológiai, vagy csak a pszichológiai jelensége-ket veszi fi gyelembe, pedig a stressz indukálta fi ziológiai válaszok szubjektumfüggőek.…”

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Psychological and biological background of the interaction between psoriasis and stress

et al. 2014

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A pikkelysömör kialakulásában és progressziójában a betegek és az orvosok jelentős hányada a stresszt tartja az egyik legfontosabb rizikótényezőnek. Mivel a stresszor és hatásai is egyaránt szubjektumfüggőek és így nehezen mérhe-tőek, sokáig csupán kevés, a stressznek a betegség kialakulásában játszott szerepét vizsgáló tanulmány készült. Az elmúlt években azonban egyre több nívós, objektív mérésekkel alátámasztott vizsgálat született, amelyek új, érté-kes adatokkal szolgáltak a háttérben zajló patofi ziológiai folyamatok megértéséhez. A szerzők a szakirodalomban fellelhető stresszexpozíciót és -percepciót befolyásoló pszichológiai (alexithymia, személyiség, hangulat) és a stresszválaszt szabályozó biológiai (kortizol-, adrenalinszintek, neurogén gyulladás) tényezőket elemző vizsgálatokat integratív, pszichoszomatikus szemlélettel tekintik át, és bemutatják, hogy az eddig főleg csak tapasztalati szinten bizonyí-tott kapcsolatot egyre több modern, magas színvonalú kutatási eredmény igazolja. Ismerve a stresszcsökkentő pszichofarmakológiai és pszichoterápiás intervenciók sikerességét a pikkelysömör kezelésében és a betegek életminő-ségének javításában, a szerzők bíznak abban, hogy tanulmányuk hozzájárul a pszichoszomatikus szemlélet szélesebb körű elterjedéséhez a mindennapi bőrgyógyászati gyakorlatban. Orv. Hetil., 2014, 155(24), 939-948. Kulcsszavak: pikkelysömör, stressz, személyiség, kortizol, neurogén gyulladás Psychological and biological background of the interaction between psoriasis and stressStress is considered as a major contributor to the development and exacerbation of psoriasis by a signifi cant proportion of patients and dermatologists. As both stressor and its effects are subject-dependent, thus extremely diffi cult to measure, our understanding of the exact role of stress in disease development was limited for a long time. In the past decade several new studies were carried out which expanded our knowledge on the pathophysiologic processes linking stress to psoriasis via with their objective measurements and the applied new techniques. The authors review the current literature of both psychological (alexithymia, personality, affect) and biological (cortisol, epinephrine, neurogenic infl ammation) factors infl uencing stress perception and response in psoriasis. Results of recent investigations support previous reports about the interaction between stress and psoriasis with objective evidence. Knowing how effective stress-reducing psychopharmacologic and psychotherapeutic interventions are in the treatment of psoriasis the authors hope that this review contributes to a wider acceptance of the psychosomatic attitude in everyday dermatologic practice.

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“…A prospective study showed that severity of psoriasis was associated with severity of stress. 49 Stress not only leads to clinical exacerbation but also has negative effects on efficacy of therapy. Fortune et al reported that stress can decrease the efficacy of psoralen ultraviolet A (PUVA).…”

Section: Stressmentioning

confidence: 99%

Epidemiology and treatment of psoriasis: a Chinese perspective

Pan¹,

Zhang²

2014

PTT

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Background: Psoriasis is a chronic inflammatory skin disease that has a negative impact on quality of life. Prevalence and management of psoriasis varies among different ethnic groups. Objectives: To evaluate the epidemiology and treatment of psoriasis from a Chinese perspective. Methods: A systematic search was performed on PubMed and the China National Knowledge Infrastructure using the following MeSH terms: "psoriasis" and ("prevalence" or "epidemiology") and "risk factor" and ("management" or "treatment"). The search included all citations from 1975 to 2013. Data were sorted by prevalence, age of onset, sex distribution, type, severity, risk factors, and management and treatment. Severity of psoriasis was classified as mild, moderate, or severe. The studies cited in this review involved Chinese subjects. Results: The prevalence of psoriasis in the People's Republic of China ranged from 0.11% to 0.47%. Genetic and environmental factors played an important role in initiation and exacerbation of psoriasis. Results showed that psoriasis can occur at any age but is more common in young and middle-aged individuals and occurs more often in men and earlier in women. Psoriasis vulgaris accounted for 82.6%-97.1% of psoriasis patients. More than 90% of patients with psoriasis were classified as mild or moderately severe. Risk factors are numerous. Management and treatment was based on classification level. Conclusion:The prevalence of psoriasis in Chinese patients is lower than that in Caucasians. A cold and dry climate, bacterial infection, diet, and stress are important risk factors for developing psoriasis. There are a variety of management and treatment options available. As such, Chinese patients with psoriasis can receive effective, safe, and individualized treatment.

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Effect of Daily Stressors on Psoriasis: A Prospective Study

Abstract: Hypotrichosiswith juvenile macular dystrophy is caused by a mutation in CDH3, encoding P-cadherin.

Cited by 62 publications

References 20 publications

Psychological Treatments for Dermatological Conditions

Psychological Treatments for Dermatological Conditions

Psychological and biological background of the interaction between psoriasis and stress

Epidemiology and treatment of psoriasis: a Chinese perspective

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