Study Identifies Factors Associated With Interest in Psychological Interventions Among Patients With Psoriasis

In certain patients with psoriasis, raising awareness about the relationship between psychological factors and the disease’s symptoms may help motivate these individuals to participate in psychological interventions that can help improve the condition.

That’s according to the results of a new cross-sectional observational study published in the journal Frontiers in Medicine.

However, “further studies are needed to investigate whether patients who show interest in a psychological intervention also actually take part in the intervention and profit from it,” authors wrote.

The study was carried out in Germany, which has a 1-year psoriasis prevalence of approximately 2.5%. However, some studies put this number as high as 8.5%. Previous research also shows patients with psoriasis can experience stress, anxiety, and depression.

“Mindfulness-based cognitive interventions often, but not always, lead to a significant improvement in the severity of the skin condition and a better quality of life,” the researchers said.

Although psychological interventions can benefit patients, “skin-related and psychological variables associated with interest in such a psychological intervention have not been identified,” they added.To address this knowledge gap, they carried out an observational study at a rehabilitation clinic for individuals with skin conditions and pneumological diseases between 2019 and 2020.

All participants were aged 18 to 65 years and had had psoriasis for at least 6 months.

Patients completed the surveys at the beginning of their clinic stay. Just over half of participants were male, and patients had an average age of 50.

Analyses revealed:

• 50.4% of patients had mild psoriasis, 37.0% had moderate psoriasis, and 12.6% had severe forms of the disease
• 47 patients had no interest in the psychological intervention, and 80 had interest
• Those interested in a short psychological intervention tended to be younger and to report more psoriasis-related skin symptoms (higher skin-related illness identity), and were more anxious and depressed, but less stressed and less mindful than patients without interest in the intervention

“These findings are partly in congruence with other studies, in which more anxious and depressed patients also had more interest in (additional) care services than less anxious and depressed persons,” the authors wrote.

This could be because individuals with these conditions might have already obtained psychological help, meaning they have a lower threshold for accessing these services, the researchers explained.

In addition, those who expressed interest in the intervention were more likely to consider nutrition and a virus/bacteria as a cause of their psoriasis than uninterested patients.

Most patients included in the study were married and living with their partner. Their average duration of psoriasis was around 21 years.

Authors hypothesize the reason less-stressed patients were more interested in a short psychological intervention is because “people who are busy participating in other programs during their stay at the rehabilitation clinic do not want to additionally take part in a psychological intervention that after all included 8 sessions of about 45-min-plus homework.”

Findings also suggest that patients’ psychological burdens are not linear to the severity of psoriasis.

Overall, these results should be replicated in larger samples that include outpatients before intervention recommendations are made.

“Future prospective studies should investigate whether there are certain characteristics, which differentiate between patients who actually take part in a psychological intervention and those who only pretend to be interested, but at the end drop out during the course of the intervention or do not participate at all,” the researchers concluded.

Reference

Stadtmüller LR, Eckardt MA, Zick C, Kupfer J, Schut C. Interest in a short psychological intervention in patients with psoriasis: a cross-sectional observational study at a German clinic. Front Med (Lausanne). Published online June 15, 2023. doi:10.3389/fmed.2023.1074632