Clinical psychiatry Anger in patients with psoriasis

Objective: Stress is known to be an important factor in initiation and progression of psoriasis, which is a chronic and inşammatory disease of the skin. Some studies revealed that, patients with psoriasis have some problems about trait anger and anger control style and anger symptoms are associated with the severity of the disease (2,3). In this study, we aimed to detect anger and anger control style in patients with psoriasis and the relationship between severity of the disease.

Methods: Fifty six patients diagnosed with psoriasis from the dermatology outpatient clinic were included into the study. Patients with psychiatric disease were excluded. Thirty volunteers with similar sociodemographic characteristics were also included into the study. Patients were asked to complete the Spielberger State-Trait Anger Expression Inventory (STAS) and Symptom Checklist-90-Revised (SCL-90-R). Severity of the disease was calculated with Psoriais Area Severity Index (PASI). Patients were divided into the three groups according to severity in terms of PASI scores (<7:mild, 7-12:moderate, >12:severe)

Results: Age, education level and gender marital status were similar between two groups. Trait-anger scores were in a range of 23.5±6.4 and anger-out scores were 15.4±4.7 in patients with psoriasis. Trait-anger scores were in a range of 20.8±6.8 and anger-out scores were 17.8±4.6 in control group. Trait-anger scores were higher in the patients group than the control group (p<0.05) and anger-out scores were lower in patients group than the control group (p>0,05). Anger control-in scores and anger control-out scores were similar between two groups. PASI scores were negatively correlated between anger control-in scores (r:-0,444). Age was negatively correlated between anger-out scores and trait-anger scores (r:-0,274) whereas age was positively correlated between anger control-out scores (p<0.05).

Conclusion: There are a few studies, which investigated the relationship between psoriasis and anger, it has been suggested that patients with psoriasis have inability to express emotional styles and disability of anger expression. In addition it has been suggested that psoriasis is a result of depressed anger. In our study, high trait-anger scores were consistent with the literature whereas association of PASI scores and anger control-in scores were not consistent with the literature.