Psychopathology and alexithymia in patients with psoriasis*

This study aimed to investigate psychopathology in patients with psoriasis based on a valid psychometric instrument, as well as on the relationship between psychopathology and alexithymia.

Methods:

108 patients with psoriasis were included in the study. Psychopathology was evaluated with the Symptom Checklist-90-Revised (SCL-90-R) and alexithymia with the Toronto Alexithymia Scale (TAS-20). Disease severity was clinically assessed using the Psoriasis Area and Severity Index.

Results:

As regards the psychopathological dimensions, female patients presented with statistically significant higher somatization, depression, anxiety, phobic anxiety, and psychoticism than males. Patients with alexithymia presented with statistically significant higher somatization, interpersonal sensitivity, anxiety, and phobic anxiety than non-alexithymic patients. Alexithymia positively correlated with somatization (r = 0.26, p < 0.01), interpersonal sensitivity (r = 0.24, p < 0.05), depression (r = 0.27, p < 0.01), anxiety (r = 0.26, p < 0.01), and phobic anxiety (r = 0.26, p < 0.01). In addition, alexithymia also contributed to the prediction of these conditions.

Study Limitations:

A larger study sample could yield safer generalized results. Nevertheless, to the best of our knowledge, this was the first study to investigate various psychopathological dimensions in patients with psoriasis.

Conclusions:

Our study results indicate that alexithymia and female sex were associated with several psychopathological dimensions in patients with psoriasis. It may be suggested that alexithymia constitutes an important factor in the development of mental disorders among patients with psoriasis.

Keywords:
Anxiety; Depression; Expressed emotion; Psoriasis; Psychopathology

		Sex
	Total Sample	Male	Female	t
Somatization	10.30 ± 8.06	7.29 ± 4.71	13.09 ± 9.45	-4.08^* ***** p < 0.001
Obsessive-compulsive	11.11 ± 6.69	10.31 ± 5.75	11.86 ± 7.43	-1.21
Interpersonal sensitivity	8.56 ± 5.92	7.67 ± 5.88	9.38 ± 5.89	-1.50
Depression	14.20 ± 9.17	12.10 ± 7.85	16.16 ±9.92	-2.35^* * p < 0.05,
Anxiety	9.31 ± 6.86	7.54 ± 5.17	10.96 ±7.80	-2.67^ p < 0.01,
Hostility	5.06 ± 4.47	5.52 ± 4.90	4.63 ± 4.03	1.04
Phobic anxiety	3.14 ± 4.15	2.19 ± 3.39	4.02 ± 4.61	-2.36^* * p < 0.05,
Paranoid ideation	5.40 ± 4.62	4.65 ± 3.96	6.09 ± 5.09	-1.63
Psychoticism	4.74 ± 5.01	3.42 ± 3.84	5.96 ± 5.66	-2.75^ p < 0.01,
Global Severity Index (GSI)	0.87 ± 0.51	0.74 ± 0.38	0.99 ± 0.59	-2.66^ p < 0.01,
Positive Symptom Distress Index (PSDI)	1.98 ± 0.50	1.95 ± 0.49	2.01 ± 0.52	-0.59
Positive Symptoms Total (PST)	37.98 ± 16.04	33.17 ± 12.79	42.45 ± 47.49	-3.16^ p < 0.01,

	PASI
	Low	High	t
Somatization	10.24 ± 8.49	10.48 ± 6.57	-0.13
Obsessive-compulsive	10.76 ± 6.66	12.28 ± 6.80	-1.00
Interpersonal sensitivity	7.71 ± 5.87	11.36 ± 5.28	-2.79^* * p < 0.01
Depression	13.51 ± 8.86	16.52 ± 9.98	-1.45
Anxiety	9.37 ± 7.12	9.12 ± 6.02	0.16
Hostility	4.95 ± 4.48	5.40 ± 4.51	-0.44
Phobic anxiety	3.08 ± 4.29	3.32 ± 3.86	-0.26
Paranoid ideation	5.10 ± 4.66	6.40 ± 4.41	-1.24
Psychoticism	4.63 ± 5.26	5.12 ± 4.17	-0.43
Global Severity Index (GSI)	0.84 ± 0.53	0.97 ± 0.44	-1.17
Positive Symptom Distress Index (PSDI)	1.94 ± 0.53	2.12 ± 0.34	-1.98
Positive Symptoms Total (PST)	37.19 ± 16.57	40.60 ± 14.10	-0.93

	Alexithymia^† † TAS>49: Existence of alexithymia, Values are presented as mean ± SD,
	No	Yes	t
Somatization	8.39 ± 6.42	11.71 ± 8.88	-2.15^* * p < 0.05.
Obsessive-compulsive	11.22 ± 5.72	11.03 ± 7.38	0.142
Interpersonal sensitivity	7.30 ± 4.97	9.48 ± 6.42	-1.99^* * p < 0.05.
Depression	12.50 ± 7.14	15.47 ± 10.30	-1.77
Anxiety	7.61 ± 5.14	10.58 ± 7.69	-2.27^* * p < 0.05.
Hostility	4.74 ± 4.43	5.29 ± 4.52	-0.63
Phobic anxiety	2.15 ± 3.22	3.87 ± 4.62	-2.16^* * p < 0.05.
Paranoid ideation	5.17 ± 4.63	5.56 ± 4.64	-0.43
Psychoticism	4.28 ± 4.80	5.08 ± 5.17	-0.82
Global Severity Index (GSI)	0.77 ± 0.39	0.94 ± 0.58	-1.90
Positive Symptom Distress Index (PSDI)	1.98 ± 0.47	1.98 ± 0.53	-0.01
Positive Symptoms Total (PST)	34.11 ± 14.83	40.85 ± 16.40	-2.20^* * p < 0.05.

	TAS (r)	Age (r)
Somatization	0.26^ p < 0.01	0.04
Obsessive-compulsive	0.09	0.08
Interpersonal sensitivity	0.24^* * p < 0.05,	-0.03
Depression	0.27^ p < 0.01	0.07
Anxiety	0.26^ p < 0.01	-0.06
Hostility	0.14	-0.09
Phobic anxiety	0.26^ p < 0.01	-0.10
Paranoid ideation	0.19	0.09
Psychoticism	0.12	-0.11
Global Severity Index (GSI)	0.27^ p < 0.01	0.01
Positive Symptom Distress Index (PSDI)	0.11	0.08
Positive Symptoms Total (PST)	0.28^ p < 0.01	-0.03

Dependent Variables	R2	F (1,106)	β
Somatization	0.07	7.88^ p < 0.01	0.26
Obsessive-compulsive	0.01	0.87	0.09
Interpersonal sensitivity	0.06	6.31^* * p < 0.05,	0.24
Depression	0.07	8.10^ p < 0.01	0.27
Anxiety	0.07	7.86^ p < 0.01	0.26
Hostility	0.02	2.02	0.14
Phobic anxiety	0.07	7.81^ p < 0.01	0.26
Paranoid ideation	0.01	1.51	0.12
Psychoticism	0.01	1.43	0.12
Global Severity Index (GSI)	0.07	8.15^ p < 0.01	0.27
Positive Symptom Distress Index (PSDI)	0.01	1.27	0.11
Positive Symptoms Total (PST)	0.08	8.69^ p < 0.01	0.28

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[1] Mailing Address: Vasiliki Efstathiou, Department of Psychiatry, University of Athens Medical School, "Attikon" University General Hospital, 1 Rimini Street, 12462 Athens, Greece. E-mail: v_efstathiou@hotmail.com

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Psychopathology and alexithymia in patients with psoriasis* * Work performed at the University of Athens Medical School, "Attikon" University General Hospital - Athens, Greece

Abstract:

Background:

Objective:

Methods:

Results:

Study Limitations:

Conclusions:

Psychopathology and alexithymia in patients with psoriasis^* * Work performed at the University of Athens Medical School, "Attikon" University General Hospital - Athens, Greece