Psoriasis Beyond the Skin: Understanding the Psychological Burden (Atena Editora)

Abstract

INTRODUCTION: Psoriasis, a chronic autoimmune skin condition, manifests through multifactorial etiology involving genetic predisposition, immune dysregulation, and environmental triggers, with clinical presentations varying across plaque, guttate, pustular, and erythrodermic subtypes. Despite primarily dermatological, psoriasis is associated with systemic implications such as psoriatic arthritis and psychological comorbidities, including depression, anxiety, and stress. Notably, psychiatric comorbidities significantly impact patients' well-being and treatment efficacy, highlighting the importance of their identification and management within comprehensive care approaches. OBJETIVE: Analyze and describe the main psychological and psychiatric aspects and effects in patients with psoriasis of the last years. METHODS: This narrative review explored the correlation between psoriasis and psychiatric or psychological aspects by conducting a thorough search across prominent databases, including MEDLINE – PubMed, COCHRANE, EMBASE, and Google Scholar. The search strategy utilized descriptors "Psoriasis" AND "psychiatric" OR "psychological" to identify relevant literature. RESULTS AND DISCUSSION: The investigation into psychological comorbidities among individuals with psoriasis revealed a significant prevalence, with depression, anxiety, and stress commonly reported across various studies. While the rates varied, depression prevalence ranged from 10% to 40%, and anxiety disorders affected approximately 20% to 40% of psoriasis patients. Psoriasis had substantial impacts on psychological well-being, including self-esteem, body image, and quality of life, with feelings of embarrassment and social withdrawal commonly reported. Psychosocial factors such as stigma and social isolation were identified as significant contributors to psychological distress, highlighting the need for targeted interventions. Cognitive-behavioral therapy and mindfulness-based approaches showed promise in managing psychological distress. Disease severity correlated with treatment outcomes and psychological burden, emphasizing the importance of holistic care approaches. Psoriasis-related psychological distress adversely impacted treatment adherence and healthcare utilization. Integrated care models involving dermatologists, psychiatrists, and psychologists were deemed essential for comprehensive management. Understanding patient perspectives and implementing holistic treatment approaches were crucial for enhancing outcomes and fostering overall well-being in individuals with psoriasis. CONCLUSION: In conclusion, our study underscores the profound psychological impact of psoriasis, as evidenced by the prevalence of depression, anxiety, and stress among affected individuals, alongside detrimental effects on self-esteem, body image, and quality of life. The presence of psychosocial factors like stigma and social isolation exacerbates these challenges, necessitating targeted interventions to alleviate psychological distress. Integrated care models involving collaboration among dermatologists, psychiatrists, and psychologists are essential for comprehensive management. By tailoring interventions to individual needs and incorporating patient perspectives, healthcare providers can enhance treatment outcomes and promote psychological well-being in individuals with psoriasis. Further research and implementation of multifaceted treatment strategies are warranted to optimize care and mitigate the psychological impact of psoriasis on affected individuals.