The Impact of Stress-Coping Strategies and the Severity of Psoriasis on Self-Esteem, Illness Acceptance and Life Satisfaction

Dermatol Ther (Heidelb). 2022 Feb;12(2):529-543. doi: 10.1007/s13555-021-00669-8. Epub 2022 Jan 18.

Abstract

Introduction: The visibility of skin lesions is a significant burden for patients with psoriasis, who experience social hostility as well as many emotional and psychological problems. The recurrent nature of cutaneous manifestations and their location are also a source of emotional distress, which in turn is one of the main factors that intensifies skin lesions in these patients. The aim of the study was to assess the impact of the severity of psoriasis and stress-coping strategies on general psychometric measures in the affected patients.

Methods: The study used a short demographic questionnaire, Psoriasis Area and Severity Index (PASI), and four standardised general psychometric tools: Rosenberg Self-Esteem Scale (SES), Satisfaction With Life Scale (SWLS), Coping Inventory for Stressful Situations (CISS) and Acceptance of Illness Scale (AIS). A total of 111 patients participated in the study.

Results: The mean PASI score was 14.0 (12.1-15.9). The mean SWLS score was below average, i.e., 18.5 (17.3-19.7), and the SES score-26.8 points (26.1-27.5)-indicated self-esteem slightly above average among patients with psoriasis. The mean stress-coping level measured with CISS was 53.6 (51.9-55.2) for the task-oriented strategy (TOS), 46.2 (43.8-48.6) for the emotion-oriented strategy (EOS) and 50.1 (48.5-51.8) for the avoidance-oriented strategy (AOS). Higher PASI was associated with lower illness acceptance among men (r = 0.48) and lower self-esteem among women (r = 0.44). The level of life satisfaction was lower in respondents with higher PASI scores (mainly in the group of women, r = 0.44).

Conclusions: Higher severity of psoriasis (PASI) and greater frequency of emotion-oriented stress-coping mechanisms (CISS) are factors that negatively affect the overall psychophysical condition of respondents.

Keywords: AIS; CISS; Illness acceptance; Life satisfaction; PASI; Psoriasis; Quality of life; SES; SWLS; Self-esteem.