Relationship of Alexithymia, Rumination and Coping Style with Psoriasis and Their Effects on The Clinical Features

OBJECTIVE A relationship has been demonstrated between stress and the increase in the skin plaques in psoriasis. In addition, psoriasis is observed in cases of severe alexithymia and stress. In depression and various psychiatric disorders, there is a relationship between rumination and both the onset and persistence of the disease. The role of rumination, being a stress related factor, was investigated in this study. METHOD The study included 91 patients with psoriasis and 93 healthy controls. All participants were evaluated with the Toronto Alexithymia Scale, Coping Style Scale, the Ruminative Thought Style Questionnaire and the Hospital Anxiety and Depression Scale. Any increase in the plaque formation after the duration of 1 month was recorded by the clinician. RESULTS In both the patient and the control groups, rumination scores were significantly correlated with the alexithymia severity scores (psoriasis group r=0.46, p<0.01; control group r=0.38, p<0.01) and the helpless coping styles scores (psoriasis group r=0.56, p<0.01; healthy r=0.57, p<0.01). When depression and anxiety scores were controlled, significant positive correlations were observed in the patient group between rumination scores and the scores on the difficulty of identifying feelings (r=0.42, p<0.01), the difficulty of describing feelings (r=0.25, p<0.05) and the scores on helpless coping styles (r=0.41, p<0.01); and also significant positive correlations were observed in the control group between the rumination scores and the scores on the difficulty of identifying feelings (r=0.27, p<0.05) and on helpless coping styles (r=0.42, p<0.01). Comparing the patients with and without increase in the plaques showed significant differences in the scores on rumination (p<0.01), difficulty of describing feelings (p <0.05) and total alexithymia scores (p<0.05). CONCLUSION The relationship of alexithymia and of passive stress coping styles with rumination may have an effect on the course of psoriasis.