Stress may be associated with increased risk of psoriasis among men
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Key takeaways:
- Compared with men with high stress resilience, those with low stress resilience had a 1.31-fold increased risk for developing psoriasis.
- They also had a 1.23-fold increased risk for psoriatic arthritis.
Low stress resilience in men may be linked to an increased risk for developing psoriasis or psoriatic arthritis, according to a study.
“There is a strong perception among patients and health care personnel that stress induces psoriasis,” Marta Laskowski, MD, PhD, of the department of dermatology and venereology at the University of Gothenburg and Sahlgrenska University Hospital, told Healio. “However, this assumption is based on results from mainly retrospective observational studies, with many limitations.”
According to the authors, these past studies have suggested that sensitivity to psychological stress increases the inflammatory response, leaving individuals vulnerable to psoriatic diseases. To evaluate this hypothesis, the authors conducted a prospective study where they analyzed the association between stress resilience levels and the risk for new onset psoriasis or psoriatic arthritis later in life.
The study data, collected from the Swedish Military Service Conscription Register, consisted of 1,669,422 men who underwent mental assessments for enlistment in the military between 1968 and 2005. Researchers followed the men’s mental health from enlistment to either the onset of psoriatic disease, emigration or death.
Results showed that compared with those with high stress resilience, men who demonstrated low stress resilience had an increased risk for developing psoriasis (HR = 1.31; 95% CI, 1.26-1.36) and psoriatic arthritis (HR = 1.23; 95% CI, 1.15-1.32).
According to the authors, there was an increase in psoriasis and psoriatic arthritis risk with lower stress resilience levels in a dose-response relationship.
When outpatient diagnoses were excluded, fully adjusted models showed that the hazard ratio of those with low stress resilience developing psoriasis or psoriatic arthritis vs. those with high stress resilience increased to 1.79 (95% CI, 1.63-1.98) and 1.53 (95% CI, 1.32-1.77), respectively.
“The results suggest that individuals with low stress resilience have an increased risk of psoriasis,” Laskowski said. “Furthermore, the results indicate that patients with psoriasis have an inherent psychological vulnerability.”
Laskowski also added, “As low stress resilience is known to increase the risk for other diseases, including depression, the psychological well-being should be taken into consideration and evaluated when treating psoriasis patients.”
Editor's note: On May 29, the author's credentials were updated to include her PhD. The editors regret the error.Perspective
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Many patients report that stress worsens their psoriasis. Many years ago, a well-done case-control study from Italy found that major stressful life events are a risk factor for developing psoriasis. I have seen this in my own practice — one of my patients developed severe psoriasis in her 80s a few months after her sister died. This new research adds to the evidence base that stress indeed plays an important role in psoriatic disease.
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