Perceived stress, stress attributions and psychological distress in psoriasis

Objective: The objective of this study was to measure causal beliefs in individuals with psoriasis and to explore their relationship with perceived stress, quality of life, psychological well-being and psoriasis severity. Methods: This study was cross-sectional in design, and patients were required to complete validated questionnaires assessing perceptions of illness, quality of life, psoriasis severity, perceived stress and psychological mood. A total of 141 individuals were recruited from two settings: an outpatient skin clinic at King's College Hospital and the Psoriasis Association. Results: A strong belief in stress/psychological attributes as a causal factor was found in 61% of the sample. This belief was significantly associated with higher levels of anxiety, depression and perceived stress (r greater than or equal to .38; P less than or equal to .0001). Perceived stress in this sample was significantly associated with a poorer level of quality of life, higher levels of anxiety and depression (r greater than or equal to .27; P less than or equal to .002) but not with psoriasis severity. Conclusions: The belief that stress is causal was associated with lower levels of psychological wellbeing. However, there was no association between perceived stress and more objective measures of psoriasis severity. (C) 2004 Elsevier Inc. All rights reserved.