Psychological interventions for patients with psoriasis vulgaris

Psoriasis Vulgaris

Psoriasis is a common inflammatory skin disease with an incidence of 0.12% in China. 1% of patients with psoriasis (about 60%) are diagnosed between the ages of 20 to 30 years. due to cosmetic defects, the chronic nature of the disease, and the high incidence of relapses, patients with psoriasis are prone to depression and suicide. 

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The psychological status of the patient has an effect on the development and prognosis of psoriasis. Therefore, psychological intervention may be beneficial in the management of psoriasis.

Psoriasis is a persistent skin disease. Although not usually a life-threatening disorder, psoriasis can have serious effects on psychological health. No effective prophylactic approach is currently available for this disease. 

The use of psychological interventions for patients with psoriasis is receiving greater attention. There may be a connection between psychological status and the development of psoriasis. 

The quality of life of patients with psoriasis is affected by depression, and patients often have little knowledge of the disease.

In addition, global scores on SCL-90 were substantially higher in patients with psoriasis than in healthy controls. Consistently, showed that compared with non-psoriatic subjects, patients with psoriasis scored higher on several SCL-90 items, including depression, anxiety, obsessive-compulsive disorder, somatization, interpersonal relationships, horror, and interpersonal sensitivity.

After a psychological intervention, the SCL-90 score improved in patients with psoriasis. In addition, the quality of life of patients with psoriasis, especially regarding sleep, self-esteem, and learning, is improved by psychological intervention. Depression and anxiety can affect the immune system and consequently worsen skin diseases. Compliance and therapeutic efficacy can be improved by psychological intervention.

Therefore, it is important to deal with somatic and psychological symptoms in patients with psoriasis. Anxiety is associated with skin injuries in 40% of patients with psoriasis, and psychological interventions can help reduce skin damage. 

Abnormal emotions give rise to the release of substance P and the proliferation of keratinocytes, which can contribute to the appearance of psoriasis. 

These findings suggest that after the psychological intervention, the main outcomes of the study group patients 'anxiety and depression scores were greatly improved compared to the psoriasis control group patients' scores. Other Data showed a reduction in the length of hospitalization and an increase in patient satisfaction in the study group compared to the psoriasis control group. 

This is a secondary result. Our results show that psychological intervention accelerates the recovery of skin lesions. Therefore, psychological intervention can play an important role in treating psoriasis. 

However, the small sample size may have affected the statistical significance. Further clinical studies with large samples are needed to confirm the effectiveness of this type of psychological intervention for psoriasis.

Research Methods

In conducting this study, researchers enrolled patients with psoriasis who had been treated in the Dermatology Department of the Second Affiliated Hospital of Xi'an Jiaotong University from March 2013 to August 2017.  

Psoriasis is diagnosed based on the criteria of Psoriasis Vulgaris. Patients with other skin disorders were excluded from the study. All patients of the intervention group (study group) received a course of narrow-band ultraviolet B phototherapy (10 times, a single dose of 0.3-0.5 J/cm2 once every 2 days). 

They were orally given xiao yin granules (Shaanxi Kanghui Pharmaceutical Co. PT., Shaanxi Province, China). All Psoriasis areas of the patient and Severity Index scores were recorded before and after treatment. 

We also registered a group of healthy subjects as a non-psoriatic control (non-psoriasis group). Control group the psoriasis control group received regular treatment and was advised to consume a high-calorie, high-protein diet and to avoid allergy-inducing foods.

Source

Li, X., Liu, L., Zhang, Y., & Li, L. (2020). Efficacy of psychological intervention for patients with psoriasis Vulgaris: a prospective study. Journal of International Medical Research, 48(10), 0300060520961674.

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