Individual Differences in Emotion Dysregulation and Social Anxiety Discriminate between High vs. Low Quality of Life in Patients with Mild Psoriasis

Abstract

A deeper understanding of how health-related quality of life relates to the clinical and individual characteristics of patients is essential for the delivery of patient-centered dermatological care. The current study aimed to examine the role of individual differences in emotion dysregulation and social anxiety in modulating quality of life in psoriatic patients. A total of 130 patients affected by psoriasis were consecutively enrolled in the study as they approached the Dermatology Unit of Sant’Orsola-Malpighi Hospital of Bologna. Clinical information gathered included illness severity, assessed with the Psoriasis Area and Severity Index (PASI) and the Body Surface Area (BSA); illness onset; familiarity; and prescribed treatment. The patient-reported outcome measures were the Dermatology Life Quality Index (DLQI), measuring the patient’s quality of life; the Psoriasis Skin Appearance Bothersomeness scale (PSAB), measuring patient’s perception of illness severity; the Difficulties in Emotion Regulation Scale (DERS), assessing emotion dysregulation traits; and the Social Interaction Anxiety Scale (SIAS), measuring anxiety about social interactions. Patients with moderate-to-severe psoriasis reported significantly lower quality of life compared to mildly affected patients. In addition, of the patients affected by mild psoriasis, those characterized by emotion dysregulation and social anxiety traits showed significantly lower levels of quality of life. Our findings suggest that individual differences in emotion dysregulation and social anxiety contribute to health-related quality of life in addition to illness severity. Therapeutic approaches that combine dermatological care with psychological support, especially focused on emotional regulation skills, may be useful to improve clinical outcomes in patients with psoriasis.