Worry and Pathological Worry in Patients with Psoriasis: Cross Sectional and Longitudinal Analyses of the Penn State Worry Questionnaire (PSWQ) in Four Samples of Patients

The purpose of the present study was to examine the psychometric properties of the Penn state Worry Questionnaire (PSWQ) in patients with psoriasis. A series of cross-sectional and longitudinal studies were undertaken to assess the reliability, stability and validity of the measure. Patients with psoriasis from four samples (consecutive attendees, anxious patients, depressed patients, and 6-month follow-up of consecutive attendees) completed the PSWQ and measures assessing related constructs of anxiety and depression (HADS) and coping (COPE). The clinical severity of patients psoriasis was also assessed by dermatologists using the Psoriasis Area and Severity Index (PASI). Exploratory factor analysis was undertaken and receiver operator characteristic (ROC) analyses were used to examine the clinical utility of the PSWQ cut-off score for normal and pathological worry. Exploratory factor analysis suggested that the PSWQ is essentially unidimensional in patients with psoriasis. Intraclass correlation demonstrated that, over a 6-month period, the reproducibility of the PSWQ total scale was good in patients with anxiety and moderate in patients with depression. ROC analysis suggested that the optimum cutoff differentiating pathological worry was > 60, which is commensurate with findings in adult mental health more generally. The PSWQ cutoff for pathological worry showed a lower specificity for depression than anxiety. The PSWQ is an appropriate measure of pathological worry in patients with psoriasis. The cutoff on the scale for pathological worry demonstrates appropriate conceptual overlap with subordinate distress categories of anxiety and depression.     

Mental health among people with psoriasis undergoing patient education in climate therapy

This study investigated the mental health of people with psoriasis undergoing patient education in climate therapy. A prospective design included a baseline assessment and two follow‐ups after a 3‐week patient education program. Participants were 254 adults. Positive mental health was measured by the mental health continuum short form (0–70), and negative mental health by the emotional distress subscale (1–4) of the health education impact questionnaire. Paired‐samples t‐tests were used to evaluate changes in mental health from baseline to follow‐up. Multiple linear regression was used to analyse the ability of socio‐demographic and clinical variables and emotional distress to predict changes in positive mental health. To predict change in negative mental health we repeated the same analysis but with a change in negative mental health as a dependent variable and positive mental health as an independent variable. The results show that positive mental health and health‐related emotional distress improved significantly from before to after the intervention by 7.1 points, p < 0.001 and 0.21 points, p < 0.001) respectively. At the second follow‐up, health‐related emotional distress remained significantly improved compared with baseline levels by 0.11 points, p = 0.004. The longer participants had lived with psoriasis ( β = 146, p = 0.027), and the presence of co‐morbid health problems (β  =  111, p = 0.051) the greater the improvement in the positive mental health immediately after the intervention. No predictors were identified for negative mental health. This study indicates that the promotion of positive mental health needs to be integrated into the climate therapy program, and sustained in their home context.     

Depictions of acne and psoriasis influence interpersonal aversion

The presence of a dermatological condition may deter contact with the affected person because it falsely signals the threat of infection. The current study investigated interpersonal aversion towards individuals with the appearance of acne and psoriasis. Participants (N = 196) either viewed a female face with the appearance of acne, psoriasis, or no visible dermatological condition. Participants rated the attractiveness of the person, and indicated their willingness for social and indirect contact with them. The person depicted with acne was rated significantly less attractive than the person with psoriasis or no dermatological condition. Participants reported significantly less willingness for indirect contact with the person depicted with acne or psoriasis compared to the person with no visible dermatological condition. In contrast, participants expressed more willingness for social contact with a person with acne than with the person with psoriasis or no dermatological condition. Group differences were significant when controlling for attractiveness ratings. Unwarranted fear of infection might underpin avoidance and discriminatory behaviour towards those with skin conditions. Further research is required to understand factors that influence avoidance of contact.     

银屑病的发病机制：天然免疫的启示

银屑病是一种常见的炎症性皮肤病,属于自身免疫病的范畴。天然免疫对保护机体免受微生物感染具有重要作用,同时天然免疫在过度激活的情况下又能够导致自身免疫病。银屑病与天然免疫功能紊乱有着密切的关系。只有充分的发挥创造性思维,密切结合临床特征,才能从天然免疫中寻找银屑病发病的相关证据。     

银屑病发病的心理社会因素及危险因素间关系的探讨——非条件Logistic回归分析和通径分析

本文对97例寻常型银屑病患者以及71例皮肤科对照组患者进行了成组病例对照性研究。相对危险度分析从36个研究因素中筛选出14项可疑危险因素;非条件Logistic回归分析提示其中8项因素有明显的致病意义;结合专业知识,对这8项危险因素进行通径分析。研究结果表明,银屑病发病是多因素综合作用的结果,心理社会危险因素通过直接或/和间接(联合)作用,影响致病过程。经通径图将各因素的作用大小、作用形式及协同作用关系较直观地描绘出来。