Well being, psychopathology and coping strategies in
psoriasis compared with atopic dermatitis: a controlled
* L Canetti,
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
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.
To compare well being, psychopathology and coping strategies of psoriatic, AD and healthy controls in a
prospective case-control study.
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).
Psoriatic patients experienced reduced well being (
= 0.007) and more anxiety and depression (
than normal controls. Psoriatic patients also displayed more severe psychopathology (
= 0.039) a more passive
attitude towards life, and loss of meaning in life (
= 0.001) as measured by the projective technique compared with
AD patients and normal controls.
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
Received: 12 September 2009; Accepted: 17 November 2009
atopic dermatitis, psoriasis, psychopathology
Confict oF interest
Psoriasis is a chronic, relapsing infammatory skin disease with a
prevalence oF 2.2%.
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.
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