Internal Medicine Residency, National Healthcare Group, Singapore.
Ann Acad Med Singap. 2018 Dec;47(12):516-522.
Psoriasis is a chronic inflammatory disease with a global prevalence of approximately 2% and significant psychiatric comorbidity. There is a great deal of existing literature assessing different aspects of psychology in psoriasis. We aimed to conduct an in-depth review of current evidence linking psoriasis to personality traits and psychiatric comorbidities, as well as factors that put these patients at risk of psychopathology.
A search of the PubMed database identified 1632 articles. We included articles studying psychological comorbidity in patients with psoriasis, looking especially at personality characteristics, and data linking psoriasis with increased risks of psychological distress, depression, anxiety and suicidality. In particular, we also evaluated subgroups in psoriasis found to be at risk.
Patients with psoriasis are more likely to be alexithymic, lack body awareness and possess a Type D personality. Alcohol, but not illicit drug use, disorders are also more common in patients with psoriasis. Patient groups who are especially at risk of psychological distress include women, younger patients, patients with a younger age of disease onset, those who self-assess their psoriasis to be severe, and those with lesions on visible or sensitive areas. Adopting motivational interviewing skills and incorporating the use of learning materials during consultations have been found to be useful.
The knowledge of personality characteristics, "at-risk" groups, and early recognition of psychological distress among patients with psoriasis can help clinicians provide better holistic care and encourage a change in patients' behaviour.
银屑病是一种慢性炎症性疾病,全球患病率约为 2%,且与显著的精神共病相关。目前有大量文献评估了银屑病患者在心理学方面的不同方面。我们旨在深入回顾目前银屑病与人格特质和精神共病相关的证据,以及使这些患者面临精神病理学风险的因素。
在 PubMed 数据库中进行搜索,共确定了 1632 篇文章。我们纳入了研究银屑病患者心理共病的文章,特别关注人格特征,并将银屑病与心理困扰、抑郁、焦虑和自杀风险增加相关的数据进行了关联。特别地,我们还评估了银屑病中被认为存在风险的亚组。
银屑病患者更容易出现述情障碍、缺乏身体意识和具有 D 型人格。此外,银屑病患者中也更常见酒精而非非法药物使用障碍。特别容易出现心理困扰的患者群体包括女性、年轻患者、疾病发病年龄较小的患者、自我评估银屑病严重程度的患者以及皮损位于可见或敏感部位的患者。采用动机性访谈技巧并在咨询中使用学习材料已被证明是有用的。
了解银屑病患者的人格特征、“高危”群体以及早期识别心理困扰,可以帮助临床医生提供更好的整体护理,并鼓励患者改变行为。