Somatoform dissociation and alexithymia in psoriasis patients

Background: Skin disorders can have significant psychosomatic components. Psoriasis, a chronic inflammatory disease is a psychosomatic disorder that has a significant negative psychological and especially socio-relational impact for the patient. The disfigurement of the skin caused by red scaly lesions can be quite painful for many patients. Psoriasis patients may experience anxiety, depression, shame about their body image, difficulty recognising and describing emotions, and experience states of somatoform dissociation. The aim of this study was to investigate the role of somatoform dissociation and alexithymia in patients with psoriasis. Methods: 50 psoriasis patients (receiving routine treatment) and 45 healthy controls were enrolled. Somatoform Dissociation Questionnaire (SDQ-20), Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Toronto Alexithymia Scale (TAS-20), Body Uneasiness Test (BUT), and Experience of Shame Scale (ESS) were administered. Student’s t-test and Pearson’s correlation were used to analyze the results. Results: The results indicated that in psoriasis patients, somatoform dissociation correlates with alexithymia total score and its externally-oriented thinking subscale. In addition, significant correlations were found between total scores of alexithymia (TAS-20) and shame (ESS), and subscales of weight phobia and body image concerns of BUT. There were also statistically significant differences between the experimental and the healthy control group in relation to somatoform dissociation (SDQ-20) and alexithymia. Conclusion: Somatoform dissociative experiences and alexithymia can be considered an adaptive cognitive mechanism in psoriasis patients.