Psychosomatic syndromes in patients with psoriasis

Aims: To investigate psychosomatic correlates of patients with psoriasis. Methods: A consecutive sample of 282 outpatients affected by chronic psoriasis (50.4 females, aged 50.1 ±12.6; median duration of illness 13 years) was recruited. Most patients (79.5%) were treated as usual and had comorbid diseases (metabolic, allergic, autoimmune, endocrine, inflammatory, respiratory, hematologic and neurologic problems) (54.3%). Disease severity was assessed with the Psoriasis Area Severity Index (PAS1) and showed mild activity in 26.2%, moderate activity in 33.3%, and severe activity in 15.6% of patients. Furthermore, patients were assessed for psychiatric disorders (MINI 5.0.0), psychosomatic syndromes (Diagnostic Criteria for Psychosomatic Research, DCPR), and disease-specific quality of life (Dermatology Quality of Life Index, DLQI). Results: The prevalence of any psychiatric disorders was 14.2% (mainly anxiety and mood disorders) whereas 67% of patients were found positive to at least one of the 12 DCPR psychosomatic syndromes. The most prevalent DCPR syndromes (>10%) were abnormal illness behaviour (AIB) (n=76, 27%; particularly, illness denial = 20.2%), alexithymia (n=83,29.4%), irritability (n=64,22%), somatization (n=44, 15.6%), and demoralization (n=34, 12.2%). Disease severity was not associated with MINI diagnoses while it was significantly associated with DCPR illness denial (x^sup 2^=10.01, p=.006), demoralization (x^sup 2^=9.13, p=.01), alexithymia (x^sup 2^=10.17, p=.0O6), AIB (/2=10.28, p=.006), and mostly psychosomatic severity (DCPR>1) (x^sup 2^=17.36, p