Relevance of psychosomatic factors in psoriasis: a case-control study.

The aim of this study was to assess the role of stressful life events, lack of social support and attachment insecurity in triggering exacerbations of psoriasis. Outpatients experiencing exacerbation of psoriasis in the last 6 months (n = 110) were compared with outpatients affected by skin conditions in which psychosomatic factors are believed to play a minor role (n = 200). Stressful life events during the last 12 months were assessed with Paykel's Interview for Recent Life Events. Perceived social support and attachment relationship were assessed with the Multidimensional Scale of Perceived Social Support and Experiences in Close Relationships Scale, respectively. In comparison with controls the patients with psoriasis reported more stressful life events in the last year. The statistically significant difference was found only for the sum of the first 25 events (odds ratio (OR) 1.98; 95% confidence interval (CI) 1.37-2.87; p < 0.001). Also, patients with psoriasis were more likely to score higher on both anxiety (OR = 1.44; CI = 1.09-1.92; p = 0.011) and avoidance attachment scale (OR = 1.49; CI = 1.04-2.14; p = 0.030), and perceived less support from their social network than did the comparison subjects. The results of this study confirm the relevance of psychosocial factors in psoriasis.