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Journal of Health Psychology
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The Physical, Psychological and Social Impact of Psoriasis

Stephen R. Rapp

Bowman Gray School of Medicine, Wake Forest University, NC, USA

M. Lyn Exum

Bowman Gray School of Medicine, Wake Forest University, NC, USA

David M. Reboussin

Bowman Gray School of Medicine, Wake Forest University, NC, USA

Steven R. Feldman

Bowman Gray School of Medicine, Wake Forest University, NC, USA

Alan Fleischer

Bowman Gray School of Medicine, Wake Forest University, NC, USA

Adele Clark

Bowman Gray School of Medicine, Wake Forest University, NC, USA

Psoriasis is a chronic, disabling skin disease affecting up to 2 percent of the population. Little is known about how physical, psychological and social features of the illness interact to create a negative impact. In this article, a biopsychosocial model of the impact of psoriasis is described, and results from a survey of 317 psoriasis patients are presented. The types of functional disability, psychological distress and disease-related stressors are described for highly strained patients (i.e. those with disease-related suicidal ideation) and compared with less strained patients (i.e. those without suicidal ideation). As predicted by the model, significantly more disability, psychological distress and disease-related stressors are found among highly strained patients. Logistical regression analysis revealed that strain is more strongly associated with disability, distress and disease-related stress level than with disease severity. Implications for research and clinical interventions are discussed.

Key Words: dermatology • psoriasis • quality of life • stress • suicide

Journal of Health Psychology, Vol. 2, No. 4, 525-537 (1997)
DOI: 10.1177/135910539700200409
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