Psychosomatic interface: psychological distress and perceived stress in psoriasis patients in a tertiary care hospital in South India

Introduction: Psoriasis is worldwide but the prevalence varies among different ethnicities. Reported prevalence of psoriasis in North India of 0.8% in the seventies has now risen to 2.8%. Psoriasis is associated with significant psychological distress and psychiatric morbidity. Data on Indian patients is limited. Indian studies reported a psychiatric morbidity ranging from 32.33% to 84%. Furthermore, aspects like correlation with type and severity has not been explored in many studies. Our study aimed to assess the psychological distress and patients' perceived stress in psoriatic patients, and explore the correlation with type and severity. Methodology: It was a cross-sectional, descriptive study. Ninety five patients of previously diagnosed cases of psoriasis, who met the inclusion and exclusion criteria were taken up for the study. The patients were interviewed using a semi-structured questionnaire for demographics followed by detailed assessment. Tools used were- (1) Psoriasis Area Severity Index (PASI), (2) General Health Questionnaire-12 (GHQ-12), and (3) Perceived Stress Scale. Statistical analysis was done using SPSS Version 16, represented as Tables. Results: Psychological distress was prevalent in psoriasis (61%). Higher distress was noted in moderate severity (73%) and in guttate variety of psoriasis (100%), with significant correlation (p=0.002). Perceived stress was also highest in moderate severity and guttate variety. Conclusions: Our study reveals that distress and stress experienced by patients need not always be proportional to the disease severity as previously reported. This necessitates evaluation of all psoriasis patients for psychological morbidity and stress irrespective of plaque severity.