Psoriasis and Psychodermatology

iibp-admin Anveshan, Issue 5

Studies estimate that in one out of three dermatological patients report of psychological factors that underlie and exacerbate their dermatologic symptoms; thus efficacious care and management must consider psychosocial characteristics of the individual and other psychological factors in disease onset, prognosis, severity, and treatment. These factors are of particular crucial significance in individuals with chronic conditions like eczema, psoriasis, urticarial, etc. (Jafferany, 2007). At first glance, behavioural sciences, behavioural medicine (including psychiatry and psychology), and dermatology may be incompatible, as the former focuses on internal and invisible states and the latter focuses on what’s vastly visible and external signs and diseases, however, what connects the two are complex systems of the human body, including the neuroendocrine and neuroimmune systems, collectively addressed as the neuro-immuno-cutaneous systems (NICS), this falls under the purview of psychocutaneous medicine or more commonly, psychodermatology. Psychodermatology or psychocutaneous medicine includes those conditions that exist on the borderline of mental health sciences (psychiatry and psychology) and dermatology. An average of 30-40% of individuals with a dermatological diagnosis express of a psychological concern underlying their skin disorder. Skin disorders that are chronic and disfiguring result in abject and debilitating psychological states leading to secondary psychiatric disorders in some cases (Yadav, Narang, and Kumaran et al., 2013).

The psychological burden of Psoriasis In individuals diagnosed with psoriasis, although biological therapies are turning points in treatment on symptomatological, physical, psychological, and emotional levels, individuals’ continue reporting feelings of isolation and social. The negative views towards psoriasis continue impacting the individual’s self-image in the long run as well, owing to the fact that it is a chronic condition. Moreover, individuals are reluctant to discuss the psychosocial burden with their medical care professionals (Trettin, Feldman, Andersen, Danbjorg, and Agerskov, 2020). The psychological burden of psoriasis is well established and not a new phenomenon to be examined. RG Jobling in 1976 pioneered a “preliminary questionnaire study of sufferers’ subjective experience”. Individuals across various severities of psoriasis continue experiencing social distress, to an extent that some may develop a phobic social avoidance due to distress regarding appearance. It demonstrates the extent of the impact that psoriasis has on an individuals’ social functioning (Ramsay & O’Reagan, 1988). The psychosocial burden or impact is a complex function of several factors like the disease severity, location of lesions, age, employment status, marital status, etc. Additionally, an individual’s’ personal disposition and characteristics may also alter disease perception, and subsequently may influence severity and flare-ups. Data suggests that social stigma, stress, physical limitations, depression, work problems, among others are the most common factors that contribute to the psychosocial burden of Psoriasis (Kimball et al., 2005). Among others, poor self-esteem, body image disturbances, internalized stigma, feelings of shame and guilt, suicidal ideation, increased substance use, anxiety, depression, alexithymia are frequently found in those diagnosed with Psoriasis (Kouris et al., 2017).

About the Author– Aishwarya L. Solanki Trained in premier mental health institution as a clinical psychologist (RCI Registered) in India. her Areas of interest include: mental health concerns of teens and young adults, chronic skin conditions, Solution Focused Brief Therapy and Adult ADHD