j.1468-3083.2009.03542.x - DOI:...

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ORIGINAL ARTICLE Well being, psychopathology and coping strategies in psoriasis compared with atopic dermatitis: a controlled study V Leibovici, , * L Canetti, S Yahalomi, R Cooper-Kazaz, § O Bonne, § A Ingber, E Bachar Department of Dermatology, Hadassah University Medical Center, Jerusalem, Israel Department of Psychology Hebrew University of Jerusalem and Department of Psychiatry, Hadassah University Medical Center, Jerusalem, Israel § Department of Psychiatry, Hadassah University Medical Center Jerusalem, Jerusalem, Israel *Correspondence: V Leibovici. E-mail: doctor_ima@yahoo.com Abstract Background There is a vast literature describing the association between psoriasis, atopic dermatitis (AD) and psychological distress. Some of these studies were uncontrolled and others used non-dermatological diseases as control, but only a few used chronic skin diseases as controls. Objective To compare well being, psychopathology and coping strategies of psoriatic, AD and healthy controls in a prospective case-control study. Methods Thirty-seven psoriatic patients and 31 AD patients were recruited from the Hadassah Ein Karem Hospital, Jerusalem, Israel, outpatient and inward clinic. The participants in the control group were 31 healthy workers and volunteers with no dermatological diseases from Kaplan Hospital, Rehovot, Israel. We used self-report questionnaires [Mental Health Inventory (MHI) and Adjustment to Chronic Skin Diseases Questionnaire (ACSD)], a projective technique (Hand Test) and assessment tools (Clinical Global Impression). Results Psoriatic patients experienced reduced well being ( P = 0.007) and more anxiety and depression ( P = 0.018) than normal controls. Psoriatic patients also displayed more severe psychopathology ( P = 0.039) a more passive attitude towards life, and loss of meaning in life ( P = 0.001) as measured by the projective technique compared with AD patients and normal controls. Conclusions We propose two explanations, derived from the psychological and the psycho-neuro-immunological domains. First, greater mental distress in psoriasis is because of the greater stigma it bears compared with AD. Alternatively, we hypothesize that the psoriatic in±ammatory process may possibly have a direct central nervous system effect. Received: 12 September 2009; Accepted: 17 November 2009 Keywords atopic dermatitis, psoriasis, psychopathology Confict oF interest None declared. Introduction Psoriasis is a chronic, relapsing infammatory skin disease with a prevalence oF 2.2%. 1 While the aetiology remains to be Fully elucidated, psoriasis is now regarded as a T-cell-dependent autoimmune disease, in which both genetic and environmental Factors play an important role. 2 Atopic dermatitis (AD) is a chronic, pruritic, infammatory disease oF unknown origin. The prevalence oF AD is rising and currently aFFecting up to 15–20% oF young children 3 and 1–3% oF adults.
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j.1468-3083.2009.03542.x - DOI:...

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