Affective temperaments profile as a predisposing factor for chronic plaque psoriasis

Document Type : Research Paper

Authors

1 Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Department of Community Medicine, School of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.

4 Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Although there is a close relationship between psoriasis and psychological issues, including affective temperaments, few studies have addressed this association. This study aimed to assess the affective temperament profile in chronic plaque psoriasis patients.
Materials and Methods: This cross-sectional study was conducted at the dermatology outpatient clinic of Imam Reza Hospital, Mashhad, during 2018-2019. In the present study, 40 psoriasis patients and 40 healthy sex- and age-matched volunteers were participated. The research instruments included Psoriasis Area and Severity Index (PASI), Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A), Beck Anxiety Inventory (BAI), and Beck Depression Inventory-II (BDI-II). The t-test, Mann-Whitney, and Chi-square tests were used to compare nominal and categorical variables. Spearman's and Pearson's tests were used to evaluate correlations.
Results: Overall, 36 out of 80 (45%) were male. Depressive, cyclothymic, and anxious temperaments were significantly more prominent in the psoriasis group (P< 0.001), while the hyperthymic score was notably higher in the control group (P= 0.023). There was no significant correlation between disease severity (PASI score) and different affective temperaments. The duration of psoriasis involvement had moderate negative correlations with all affective temperaments (P< 0.05) except for hyperthymic temperament. The prevalence of anxiety (80% vs. 30%; P< 0.001) and depression (60% vs. 32.5%; P= 0.009) were significantly higher in psoriasis patients compared with the controls.
Conclusion: It seems that cyclothymic, depressive, anxious temperaments, as well as anxiety, and depression were more prevalent in psoriasis patients. However, these were not correlated with the disease severity.

Keywords


  1. Furue M, Nakahara T, Tsuji G. Therapy and prevention of atopic dermatitis and psoriasis. Switzerland, Basel: MDPI Books; 2020.
  2. Feldman SR. Psoriasis: Epidemiology, clinical manifestations, and diagnosis. UpToDate; 2022.
  3. Kamiya K, Kishimoto M, Sugai J, Komine M, Ohtsuki M. Risk factors for the development of psoriasis. Int J Mol Sci 2019; 20(18): 4347.
  4. Rendon A, Schäkel K. Psoriasis pathogenesis and treatment. Int J Mol Sci 2019; 20(6): 1475.
  5. Amin M, Lee EB, Tsai T-F, Wu JJ. Psoriasis and co-morbidity. Acta Derm Venereol 2020; 100(3): 80-6.
  6. Dhana A, Yen H, Yen H, Cho E. All-cause and cause-specific mortality in psoriasis: A systematic review and meta-analysis. J Am Acad Dermatol 2019; 80(5): 1332-43.
  7. Chen A, Beck KM, Tan E, Koo J. Stigmatization in psoriasis. J Psoriasis Psoriatic Arthritis 2018; 3(3): 100-06.
  8. Torales J, Echeverría C, Barrios I, García O, O'Higgins M, Castaldelli-Maia JM, et al. Psychodermatological mechanisms of psoriasis. Dermatol Ther 2020; 33(6): e13827.
  9. Stewart TJ, Tong W, Whitfeld MJ. The associations between psychological stress and psoriasis: a systematic review. Int J Dermatol 2018; 57(11): 1275-82.
  10. Yang H, Zheng J. Influence of stress on the development of psoriasis. Clin Exp Dermatol 2020; 45(3): 284-8.
  11. Ayasse MT, Buddenkotte J, Alam M, Steinhoff M. Role of neuroimmune circuits and pruritus in psoriasis. Exp Dermatol 2020; 29(4): 414-26.
  12. Thompson NJ, Fiorillo D, Rothbaum BO, Ressler KJ, Michopoulos V. Coping strategies as mediators in relation to resilience and posttraumatic stress disorder. J Affect Disord 2018; 225: 153-9.
  13. Jacoby R, Greenfeld Barsky K, Porat T, Harel S, Hanalis Miller T, Goldzweig G. Individual stress response patterns: Preliminary findings and possible implications. PLoS One 2021; 16(8): e0255889.
  14. Pancar Yuksel E, Durmus D, Sarisoy G. Perceived stress, life events, fatigue and temperament in patients with psoriasis. J Int Med Res 2019; 47(9): 4284-91.
  15. Marek-Józefowicz L, Jaracz M, Borkowska A. [Affective temperament, depressive symptoms and interleukins in patients with psoriasis]. Postepy Dermatol Alergol 2021; 38(1): 137-43. (Polish)
  16. El Kefi H, Zaara SY, Souissi S, Jouini F, Edhif S, Oumaya A, et al. 1487–Affective temperament and psoriasis: A report of 65 adult cases. Eur Psychiatry 2013; 28(S1): 1.
  17. Rezaei Ardani A, Tara F, Hatami SB, Naghizadeh Kashani S, Emadzadeh M, Nahidi M. Affective temperaments and the risk of gestational diabetes mellitus. Int J Psychiatry Clin Pract 2022; 26(1): 23-8.
  18. Rezaei Ardani A, Tara F, Naghizadeh Kashani S, Hatami SB, Emadzadeh M, Nahidi M. Is gestational hypertension associated with affective temperaments? Hypertens Pregnancy 2020; 39(2): 159-64.
  19. Ardani AR, Hosseini FF, Asadpour Z, Hashemian AM, Dadpour B, Nahidi M. Affective temperaments, as measured by TEMPS-A, among self-poisoning nonlethal suicide attempters. Psychiatry Res 2017; 247: 125-9.
  20. Olivier C, Robert PD, Daihung D, Urba G, Catalin MP, Hywel W, et al. The risk of depression, anxiety, and suicidality in patients with psoriasis: A population-based cohort study. Arch Dermatol 2010; 146(8): 891-5.
  21. Lim DS, Bewley A, Oon HH. Psychological profile of patients with psoriasis. Ann Acad Med Singap 2018; 47(12): 516-22.
  22. Jing D, Xiao H, Shen M, Chen X, Han X, Kuang Y, et al. Association of psoriasis with anxiety and depression: A case-control study in Chinese patients. Front Med 2021; 8: 771645.
  23. Khalili N, Panjalizadeh ME, Jahani Y. [Validation of the brief Persian version of the affective temperament auto-questionnaire TEMPS-A]. Iranian journal of psychiatry and clinical psychology 2018; 24(1): 92-107. (Persian)
  24. Figueira ML, Caeiro L, Ferro A, Severino L, Duarte PM, Abreu M, et al. Validation of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A): Portuguese-Lisbon version. J Affect Disord 2008; 111(2-3): 193-203.
  25. Derakhshanpour F, Aazh H, Danesh A, Golchoobifar AS. Validation of a short Persian-language version of the temperament evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire. Minerva Psychiatr 2021; 62(1): 29-36.
  26. Toledano-Toledano F, Moral de la Rubia J, Domínguez-Guedea MT, Nabors LA, Barcelata-Eguiarte BE, Rocha-Pérez E, et al. Validity and reliability of the Beck Anxiety Inventory (BAI) for family caregivers of children with cancer. Int J Environ Res Public Health 2020; 17(21): 7765.
  27. Kaviani H, Mousavi A. [Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI)]. Tehran University medical journal 2008; 66(2): 136-40. (Persian)
  28. Tran B, Ho RC, Hall BJ. Systematic Approaches to Mental Health Care and Promotion. Frontiers Media SA; 2020.
  29. Zarghami M, Taghizadeh F, Moosazadeh M, Kheradmand M, Heydari K. Validity of self-reporting depression in the Tabari cohort study population. Neuropsychopharmacol Rep 2020; 40(4): 342-7.
  30. Karam EG, Salamoun MM, Yeretzian JS, Mneimneh Z, Karam AN, Fayyad J. Temperament and major depressive disorder. Ann Gen Psychiatry 2010; 9(1): S75.
  31. Kılıç A, Güleç M, Gül Ü, Güleç H. Temperament and character profile of patients with psoriasis. J Eur Acad Dermatol Venereol 2008; 22(5): 537-42.
  32. Litaiem N, Youssef S, Jabeur K, Dhaoui MR, Doss N. Affective temperament profile in psoriasis patients in Tunisia using TEMPS-A. J Affect Disord 2013; 151(1): 321-4.
  33. Rousset L, Halioua B. Stress and psoriasis. Int J Dermatol 2018; 57(10): 1165-72.
  34. Akiskal H, Akiskal KK. In search of Aristotle: temperament, human nature, melancholia, creativity and eminence. J Affect Disord 2007; 100(1-3): 1-6.
  35. Rihmer Z, Akiskal KK, Rihmer A, Akiskal HS. Current research on affective temperaments. Curr Opin Psychiatry 2009; 23(1): 12-8.
  36. Yan D, Ahn R, Leslie S, Liao W. Clinical and genetic risk factors associated with psoriatic arthritis among patients with psoriasis. Dermatol Ther 2018; 8(4): 593-604.