THE RELATION BETWEEN ENVIRONMENTAL STRESSORS AND PSYCHIATRIC CO-MORBIDITY TO CLINICAL PROFILE AND SEVERITY OF PSORIASIS

Abstract

Psoriasis is connected with higher rates of depression and anxiety, and people with severe psoriasis die, on average, four years younger than people without the disease. The impact of psoriasis on patients’ overall quality of life is significant, broad, and deep, including effects on emotional well-being, psychological stress, self-esteem, relationship, work, social activities, financial burden, and even physical function. Psoriasis occurs worldwide and has no gender preference; however, its prevalence and incidence estimates show ethnic and geographic variations, being generally more common in the colder north than in the tropics. A performed systematic review of published population-based studies on the incidence and prevalence of psoriasis and concluded that the prevalence in children ranged from 0% (Taiwan) to 2.1% (Italy), and in adults it varied from 0.91% (United States) to 8.5% (Norway). Many environmental factors have been linked to psoriasis, and have been implicated in, such as disease process initiation or exacerbation. However, conclusive evidence is so far lacking. Environmental risk factors include; trauma, infections, drugs, sunlight, the 3-month postpartum period, stress, seasonal variation, and smoking and alcohol. The relationship between stress and psoriasis is likely more complicated. A significant association of psychiatric morbidities in psoriasis was recorded in 25 (50%) in psoriatic patients. The proportion of major depressive disorders (MDD) was among psoriasis patients 15 (30.0%). However, patients in terms of anxiety disorders were 8% in psoriasis. In patients with psoriasis, MDD was found highest (30.0%) followed by anxiety disorders (8.0%), adjustment disorder (4.0%) and somatoform disorder not otherwise specified (2.0%). The impact of psoriasis on patients’ overall QoL is broad and deep, including effects on emotional wellbeing, psychological stress, self-esteem, relationships, work, social activities, financial burden, and even physical function (particularly in patients with coexistent psoriasis arthritis). Aims of the study were identify patients with their various clinical profile and severity, investigate the types of stressors, the types of quality of life, the types of psychosocial factors, and studying the correlation between the co-morbid psychiatric disorders and the forms and severity of clinical profile of psoriasis.