HRQoL IN PATIENTS WITH PSORIASIS. ASSOCIATIONS WITH THE ILLNESS SEVERITY, PERSONALITY PATTERNS AND PSYCHIATRIC SYMPTOMS

Psoriasis is a chronic inflammatory skin disorder with a complex immune-mediated pathophysiology affecting between 0.91% and 8.5% of the general population. Various psychopathological conditions are associated with psoriasis, and they either result from or contribute to psoriasis. Several studies reported lower quality of life in subjects with psoriasis and psychiatric presentations compared to patients with psoriasis alone. This study aimed at evaluating the quality of life in patients with psoriasis related to the illness severity, psychiatric symptoms and personality patterns. Notably, no research has examined the relationship between quality of life and personality patterns using clinician assessment. Methods: The study is based on a multi-method and multi-informant design. 50 patients, 25 assigned to a biologic therapy and 25 to a topical therapy, were evaluated with self-report measures, such as the Symptom Checklist-90-R (SCL-90R) and Psoriasis Index of Quality of Life (PSORIQoL). Patients’ personality and psychological functioning were also evaluated by external raters using the Shedler-Westen Assessment Procedure (SWAP- 200) (based on the Clinical Diagnostic Interview; CDI). Finally, the severity and area of their psoriatic lesions were evaluated with the Psoriasis Area Severity Index (PASI). Results: Significant differences between groups (biologic vs topical therapy) were found in PASI scores: patients assigned to biological therapy have shown lower levels of illness severity. Nevertheless, no differences between groups were found in PSORIQoL scores. The quality of life was negatively associated with various dimensions of SCL-90R, as well as with borderline and dependent personality styles/disorders; on the contrary, it did not relate to PASI. Conclusions: Results seem to suggest that the quality of life in psoriatic patients is more influenced by personality characteristic and psychiatric symptoms rather than by the severity of psoriatic lesions.