Mazzetti M, Mozzetta A, Soavi G C, Andreoli E, Foglio Bonda P G, Puddu P, Decaminada F
Instituto Dermopatico dell'Immacolata, Rome, Italy.
Acta Derm Venereol Suppl (Stockh). 1994;186:62-4.
The aim of this investigation was to learn how a stressful event, often very mild, can determine a relapse of psoriasis. The research was carried out with clinical interviews and with the administration of Rorschach Psychoreactive, MMPI and H-T-P tests to 80 in-patients. Our data revealed a high prevalence of psychic disorders: 71.2% of patients showed symptoms which allowed a precise psychiatric diagnosis based on DSM-III-R criteria. 35% had personality disorders, 17.5% were moody, 12.5% were anxious and 6.25% had a schizophrenic trait. The analysis of the stressful events enabled us to determine the presence of a specific event in 88.7% of cases. For the majority of patients, the stressful event was felt as very mild: 67.6% of patients reported the existence of a low-impact stressful event according to the DSM-III-R classification. The average evaluation of the stressful event for all patients, based on a five-stage rating (ranging from 2 'light' to 6 'catastrophic') was 2.56. In conclusion, the analysis of the psychic conditions of in-patients showed that the importance in inducing an acute episode of psoriasis is the meaning of a stressful event as experienced by the patient, i.e. the questioning of his own identity, rather than the intensity of the aforementioned stressful event. In this case, the disease appears to be an attempt to express a defensive somatic response to a possible identity crisis.
本调查的目的是了解一个压力事件（通常非常轻微）如何引发银屑病复发。研究通过对80名住院患者进行临床访谈以及实施罗夏墨迹心理反应测验、明尼苏达多相人格测验和绘人-房-树测验来开展。我们的数据显示精神障碍的患病率很高：71.2%的患者表现出的症状允许根据《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）标准进行精确的精神科诊断。35%的患者有人格障碍，17.5%的患者情绪多变，12.5%的患者焦虑，6.25%的患者有精神分裂症特质。对压力事件的分析使我们能够确定88.7%的病例中存在特定事件。对大多数患者来说，压力事件被认为非常轻微：根据DSM-III-R分类，67.6%的患者报告存在低影响的压力事件。基于五阶段评分（从2“轻度”到6“灾难性”）对所有患者压力事件的平均评分为2.56。总之，对住院患者心理状况的分析表明，引发银屑病急性发作的重要因素是患者所经历的压力事件的意义，即对其自身身份的质疑，而非上述压力事件的强度。在这种情况下，疾病似乎是对可能的身份危机表达防御性躯体反应的一种尝试。
