Reversibility of alexithymia with effective treatment of moderate‐to‐severe psoriasis: longitudinal data from
            <scp>EPIDEPSO</scp>

Sampogna, Francesca; Puig, L.; Spuls, Phyllis I.; Girolomoni, Giampiero; Radtke, MA; Kirby, Brian; Brunori, M.; Bergmans, Paul; Smirnov, Pavel; Rundle, J. S. H.; Castiglia, Antonella; Lavie, Frédéric; Paul, C.

doi:10.1111/bjd.17259

Cited by 18 publications

(15 citation statements)

References 27 publications

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“…Moreover, alexi-thymia was recognized as contributor to the development of somatization, interpersonal sensitivity, anxiety, and phobic anxiety in psoriasis patients [13]. However, it is considered a stable personality trait that, unlike anxiety and depression, should not change over time, but a reversion with therapeutic interventions has been reported, suggesting that alexithymia might be partly modifiable [28,29]. The current hypothesis is that a dimension of alexithymia, "trait alexithymia," constitutes a psychological trait that does not change over time, while another dimension, "state alexithymia," may vary based on psychological status or by therapeutic intervention impacting on patients' quality of life and, more in general, on well-being [22,28,29].…”

Section: Discussionmentioning

confidence: 99%

Disease Severity Is Associated with Alexithymia in Patients with Atopic Dermatitis

Chiricozzi¹,

Esposito

Gisondi

et al. 2020

Dermatology

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Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder that is associated with higher rates of psychological disorders, but limited evidence supported the association with alexithymia, a psychoaffective dysfunction. Objectives: This study was aimed to investigate the occurrence of alexithymia in AD patients, compared to healthy subjects. Methods: This cross-sectional study assessed AD severity by the Eczema Area and Severity Index (EASI) score, sleeplessness and itch by a numeric rating scale (NRS), and alexithymia by the 20-item Toronto Alexithymia Scale (TAS-20) score. The association between disease characteristics and alexithymia was evaluated through several logistic regression models. Results: 202 AD patients and 240 healthy subjects were included in this study. The alexithymic personality trait (TAS-20 ≥51) was more frequently observed among AD patients compared to the control group (62.4% [126/202] vs. 29.2% [70/240], p < 0.0001). In particular, alexithymia (TAS-20 score ≥61) was detected in a significantly higher number of AD patients than in the controls (27.7% [56/202] vs. 7.5% [18/240]; p < 0.0001), whereas borderline alexithymia was detected in 34.6% (70/202) of AD patients compared to 21.7% of healthy controls. Alexithymia was more common among severe AD patients (43.6%) compared to mild AD patients (15.6%) and correlated with itch intensity and sleep disturbances. Among clinical variables, ordered logistic regression analyses revealed disease severity as predictor of alexithymia. Indeed, univariate analysis showed EASI score, sleep NRS, and itch NRS being significantly associated with alexithymia, while a multivariate model identified increased EASI score values as predicting factor. Conclusion:This study described alexithymia in AD patients correlating its occurrence with clinical AD severity markers (EASI score, itch, and sleeplessness) and identifying the increase in EASI score as predicting factor.

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Section: Discussionmentioning

confidence: 99%

Disease Severity Is Associated with Alexithymia in Patients with Atopic Dermatitis

Chiricozzi¹,

Esposito

Gisondi

et al. 2020

Dermatology

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“…On the other hand, Bahmer and colleagues found that patients with psoriasis and atopic eczema differed regarding personality and character traits, with patients with psoriasis being less ambitious and narcissistic and patients with atopic eczema being less self-critical than the population average. 22 In addition, psoriasis has been linked to alexithymia, 46,47 which involves difficulties in recognizing and describing emotions. Such psychometric differences might lead to different ways of perceiving and coping with the respective skin disease, 48 which could explain the different effects of disease severity on PA.…”

Section: The Role Of Dermatologic Disease Severitymentioning

confidence: 99%

Happiness in dermatology: a holistic evaluation of the mental burden of skin diseases

Schuster

Ziehfreund

Albrecht

et al. 2020

Acad Dermatol Venereol

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Background According to the World Health Organization, mental health is a state of well-being and not merely the absence of disease. However, studies exploring subjective well-being in patients with skin diseases are very rare. Objectives To assess subjective well-being, i.e. 'happiness', in patients with different skin diseases and to compare them to other patient groups and healthy controls. Methods A cross-sectional study was conducted from 12/2017 to 04/2019. Patients receiving in-or outpatient care for psoriasis, atopic eczema, nummular eczema, mastocytosis, skin cancer (malignant melanoma and keratinocyte carcinoma), human immunodeficiency virus (HIV) or chronic inflammatory bowel diseases (Crohn's disease and ulcerative colitis) were recruited at two hospitals in Bavaria, Germany. Healthy individuals living in or near Munich served as a control group. All participants filled in a questionnaire assessing happiness, measured as positive affect (PA), negative affect and satisfaction with life (SWL; together representing subjective well-being) and a heuristic evaluation of one's own happiness. Results Data from 229 dermatologic patients (53.3 AE 18.5 years, 48% women), 49 patients with inflammatory bowel diseases (48.9 AE 18.7 years, 43% women), 49 patients with HIV (46 AE 10.1 years, 10% women) and 106 healthy controls (38.4 AE 13.4 years, 49% women) were analysed. Compared to the controls, dermatologic patients reported lower heuristic happiness (P = 0.023) and PA (P = 0.001) but higher SWL (P = 0.043). Patients with psoriasis and atopic eczema reported the lowest happiness, as they reported significantly lower PA (P = 0.032 and P < 0.001) and heuristic happiness (P = 0.002 and P = 0.015) than the control group. Patients with skin cancer reported higher SWL than the control group (P = 0.003). Dermatologic patients reported lower happiness than patients with HIV but reported greater happiness than patients with IBD. Conclusions Dermatologic patients experience lower levels of happiness, especially PA, compared to healthy controls. As PA is linked to desirable health outcomes, targeting PA could be a promising holistic approach for the treatment of skin diseases.

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“…With the next-generation biologics, IL-23 and IL-17 inhibitors, 90% PASI reductions and even full clearance of disease are realistic goals. While this disease lacks a long-term structural damage component found in the other indications of TNF blockade, it is associated with compromised psychosocial status, which the evidence suggests might be limited or even reversed with successful treatment 256. Treatment guidelines now reflect tight-control and treat-to-target approaches with use of TNF inhibitors and other biologics recommended if phototherapy and conventional systemic agents fail to provide an adequate response 241.…”

Section: Changes In Treatment Paradigms Due To the Advent Of Tnf Blocmentioning

confidence: 99%

<p>Remicade<sup>®</sup> (infliximab): 20 years of contributions to science and medicine</p>

Melsheimer¹,

Geldhof²,

Apaolaza³

et al. 2019

BTT

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On August 24, 1998, Remicade ® (infliximab), the first tumor necrosis factor-α (TNF) inhibitor, received its initial marketing approval from the US Food and Drug Administration for the treatment of Crohn’s disease. Subsequently, Remicade was approved in another five adult and two pediatric indications both in the USA and across the globe. In the 20 years since this first approval, Remicade has made several important contributions to the advancement of science and medicine: 1) clinical trials with Remicade established the proof of concept that targeted therapy can be effective in immune-mediated inflammatory diseases; 2) as the first monoclonal antibody approved for use in a chronic condition, Remicade helped in identifying methods of administering large, foreign proteins repeatedly while limiting the body’s immune response to them; 3) the need to establish Remicade’s safety profile required developing new methods and setting new standards for postmarketing safety studies, specifically in the real-world setting, in terms of approach, size, and duration of follow-up; 4) the study of Remicade has improved our understanding of TNF’s role in the immune system, as well as our understanding of the pathophysiology of a range of diseases characterized by chronic inflammation; and 5) Remicade and other TNF inhibitors have transformed treatment practices in these chronic inflammatory diseases: remission has become a realistic goal of therapy and long-term disability resulting from structural damage can be prevented. This paper reviews how, over the course of its development and 20 years of use in clinical practice, Remicade was able to make these contributions.

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Reversibility of alexithymia with effective treatment of moderate‐to‐severe psoriasis: longitudinal data from EPIDEPSO

Abstract: What's already known about this topic?• Alexithymia, the inability to identify and express emotions, is highly prevalent in patients with psoriasis.• Patients with alexithymia have a high disease burden, with impaired quality of life, anxiety and depression.

Cited by 18 publications

References 27 publications

Disease Severity Is Associated with Alexithymia in Patients with Atopic Dermatitis

Disease Severity Is Associated with Alexithymia in Patients with Atopic Dermatitis

Happiness in dermatology: a holistic evaluation of the mental burden of skin diseases

<p>Remicade<sup>®</sup> (infliximab): 20 years of contributions to science and medicine</p>

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