Gupta M A, Gupta A K, Haberman H F
Gen Hosp Psychiatry. 1987 May;9(3):157-66. doi: 10.1016/0163-8343(87)90001-6.
Psychosocial factors are important in the onset and/or exacerbation of psoriasis in 40%-80% of cases. Yet psoriasis has received little attention in the recent psychiatric literature. A subgroup of psoriatics appear to be "stress reactors" and these patients may have a better long-term prognosis. Identification of such patients early in the course of treatment and incorporation of specific psychosocial interventions in their overall treatment regimen may improve the course of illness. Psoriasis has also been associated with suicide and an increased prevalence of alcoholism. The disturbances in body image perception and the effect of psoriasis on interpersonal, social, and occupational functioning can further contribute to the overall morbidity, especially if psoriasis first occurs during a developmentally critical period like adolescence. Certain biochemical and physiologic correlates of psoriasis of interest to the psychiatrist such as exacerbation of psoriasis with lithium therapy and increased cutaneous blood flow are discussed. Finally, some practical guidelines are provided for psychosocial interventions in psoriasis.
心理社会因素在40%-80%的银屑病发病和/或病情加重中起着重要作用。然而，银屑病在近期的精神病学文献中很少受到关注。一部分银屑病患者似乎是“应激反应者”，这些患者可能有较好的长期预后。在治疗过程中尽早识别这类患者，并在其整体治疗方案中纳入特定的心理社会干预措施，可能会改善病情。银屑病还与自杀和酒精中毒患病率增加有关。身体形象认知障碍以及银屑病对人际、社交和职业功能的影响会进一步加重整体发病率，尤其是如果银屑病在青春期等发育关键期首次出现。文中还讨论了精神病医生感兴趣的银屑病的某些生化和生理关联，如锂治疗可加重银屑病以及皮肤血流量增加。最后，提供了一些针对银屑病心理社会干预的实用指南。
