Friday, October 28, 2005

Psoriasis And The Social Connection

People with psoriasis perceive they have less social support, have difficulty expressing their feelings and have more trouble with social relationships than others, a new study shows.
Newswise — The study says these life stresses may make them more prone to outbreaks of their psoriasis.
Researchers led by Angelo Picardi, M.D., suggest in the November-December issue of Psychomatics that “psychological interventions aimed at increasing emotional awareness, fostering the security felt in close interpersonal relationships and increasing social support might help reduce” outbreaks or at least lessen their severity.
The scientists from La Sapienza University in Rome studied 33 patients with psoriasis who had a recent worsening of their symptoms and 73 patients who had other minor skin conditions. Both groups were asked about stressful events over the past year, specifically about their social and emotional lives.
Psoriasis is an inflammatory skin condition that affects about 7 million Americans. The study participants had plaque psoriasis, the most common form, which appears as patches of raised, reddish skin covered by silvery-white scales and forms most commonly on the elbows, knees and lower back.
The researchers found that, in comparison with the group that had minor conditions, the patients with a recent psoriasis outbreak had lower perceived social support, more characteristics of bottled-up emotions and higher “attachment-related anxiety.” There were no differences in their scores, however, on measures that tested experiences in close relationships.
People who are high in attachment-related anxiety tend to worry about whether their partners really love them and often fear rejection. In addition, some people are more avoidant that others. People who are high in attachment-related avoidance are less comfortable depending on and opening up to others and are reluctant to ask their partners for comfort or support.
Age, gender, education, marital status and alcohol consumption were taken into consideration when assessing patient outcomes.
“Theoretical models emphasize that these persons tend to rely more on cognition and cognitive information than on feelings and emotional information,” Picardi said. “Clearly, self-regulation is compromised both internally and externally, which may increase susceptibility to disease.
“Perceived social support is a subjective measure, but when the level is higher, it is associated with better health,” Picardi added. “Immunological processes play a major role in the pathophysiology of psoriasis.” He said that prior research has shown that stress has particular effects on the skin, including slower wound healing, greater susceptibility of skin cells and a higher propensity for inflammation.
Picardi A, et al. Stress, social support, emotional regulation, and exacerbation of diffuse plaque psoriasis. Psychomatics 46(6), 2005.