Background: Stress or psychological distress is often described as a causative or maintaining factor in psoriasis.\nPsychological traits may influence the appraisal, interpretation and coping ability regarding stressful situations.\nDetailed investigations of psychological traits in relation to stress reactivity in psoriasis are rare. The aim of this\nstudy was to examine whether patients with psoriasis who report an association between psychological distress\nand exacerbation, ââ?¬Å?stress reactorsââ?¬Â (SRs), differ psychologically from those with no stress reactivity ââ?¬Å?non-stress\nreactorsââ?¬Â (NSRs).\nMethods: This cross-sectional study was conducted among 101 consecutively recruited outpatients with plaque\npsoriasis. A psychosocial interview was performed including questions concerning stress reactivity in relation to\nonset and exacerbation. Three validated self-rating scales were used: Spielberger State-Trait Anxiety Inventory (STAI,\nForm-Y), Beck Depression Inventory (BDI-II) and Swedish Universities Scales of Personality (SSP). Independent samples\nt-tests, Chi-square tests and one-way ANOVA analyses were used for group comparisons when appropriate. A logistic\nregression model was designed with SR as the dependent variable.\nResults: Sixty-four patients (63%) reported a subjective association between disease exacerbation and stress (SRs).\nPatients defined as SRs reported significantly higher mean scores regarding state and trait anxiety, depression, and also\nfive SSP scale personality traits, i.e. somatic trait anxiety, psychic trait anxiety, stress susceptibility, lack of assertiveness\nand mistrust, compared with NSRs. In multivariate analysis, SSP-stress susceptibility was the strongest explanatory\nvariable for SR, i.e. OR (95% CI) = 1.13 (1.02 ââ?¬â?? 1.24), p = 0.018.\nConclusion: According to our results, patients who perceive stress as a causal factor in their psoriasis might have a\nmore vulnerable psychological constitution. This finding suggests important opportunities for clinicians to identify\npatients who may benefit from additional psychological exploration and support
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