Underlying disease |
Disease severity |
Psoriasis lesions cause physical discomfort because they crack the skin, cause pruritus and bleeding, desquamate, stain, and cause social embarrassment. |
Lower overall health status, depression and other psychological changes, cardiovascular disease, and malignancies are related to more severe illness. |
Special characteristics of psoriasis |
Nail disease or disease located in visible areas and psoriatic arthritis are associated with more difficulty in dealing with the disease. |
Gender and age |
Younger and older people are the most impacted. |
Women have concerns about pregnancy, its risks, fear of stopping treatment or worsening the disease or bringing complications to the fetus. |
Early symptoms |
In childhood or adolescence, the most vulnerable phase, there are fewer adaptive mechanisms to protect against personality damage. Living with negative reactions from classmates influences academic performance, training, opportunities and career choices, first social contacts and partnerships. |
It also means a longer duration of the disease and more time to experience its complications. |
Chronicity |
The perception of prolonged illness requires adaptation to living with psoriasis and can have a major negative impact. |
Disease duration |
It may indicate a longer period of exposure to factors that are potentially harmful throughout the course of life. Related to the concept of chronicity. |
Treatment |
The obligation to maintain medication for the long term can cause anxiety, discomfort, lack of stimulation and reduce adherence. The cost and fear of adverse events also have a negative influence. |
Comorbidities |
Obesity |
It contributes to low self-esteem. Individuals stop performing physical activities, due to pain or embarrassment, or depression, which contributes to weight gain. The systemic inflammation of psoriasis itself is associated with a greater chance of obesity and metabolic syndrome. |
Cardiovascular comorbidities |
They affect several functions, including performing exercise, physical limitations, which may be aggravated by pain, indirectly compromising sexual function. |
Other associated diseases |
Inflammatory bowel disease and arthritis are factors that add up, aggravating low self-esteem, the need to seek health services, undergoing exams and using medications, causing more limitations. |
Higher number of hospitalizations |
Patients may have severe forms such as pustular or erythrodermic psoriasis, complications from comorbidities and treatments, requiring hospitalization. |
Psychosocial |
Low level of schooling |
The individual has difficulty in school relationships, with classmates and teachers, difficulty in interacting, concentrating, missing school to attend appointments or undergo exams, social embarrassment due to the presence of lesions. There is a tendency to abandon studies or not invest in labor training, especially in the lower social classes. |
Stigmatization |
Feeling of being stigmatized and disregarded by others. |
Lack of social support |
Participation of family, friends or other caregivers, with psychological and material support. Improves coping with chronic illnesses in general. |
Negative impact on professional life |
Lack of schooling and adequate training, greater number of days lost at work, low productivity due to pain or skin lesions. |
Negative mood |
Anger, depression, sadness, helplessness and loss of autonomy. |
Coping strategies |
Well-described correlation between psychological burden and coping behavior in psoriasis. Negative coping is related to anxiety, depression and anguish due to the disease. |
Quality of life |
Influenced by important predictors: time needed for treatment, social anxiety, negative coping, clinical severity, satisfaction with treatment. |
Risk behaviors |
Smoking, alcoholism, drug addiction. |
Compulsive food addiction. |
They are associated with more anxiety and lack of a coping strategy. They worsen comorbidities such as obesity and increase cardiovascular risk. |