Features of the pathodynamics of psychosomatic pathology (based on the psoriasis model) under the influence of large-scale social crises

Abstract

Background. Psychoemotional stress is a relevant factor in the recurrence of psoriasis. In recent years, the population of Ukraine has been experiencing strong social stress related to the COVID-19 pandemic and the war. Studying the influence of social stress on the recurrence of psoriasis allows for the personalization of therapeutic and preventive measures aimed at normalizing the psycho-emotional sphere in patients with psoriasis. Purpose – to investigate the relationship between the influence of stress and the pathodynamics of psychosomatic pathology (on the model of psoriasis) during periods of social upheavals, to determine, in the future, targets of medical and psychological support of the population during large-scale social crises. Objectives of the study: to determine the frequency of recurrence of psoriasis during the action of powerful social stress, their connection with social stress, and features of psychopathological manifestations during exacerbations taking into account the scale. Materials and Methods. 39 men and 44 women with psoriasis were examined using a specially developed online questionnaire. Results. It was found that 36.1% of patients had an exacerbation of psoriasis in the first year of the COVID-19 pandemic (38.6% of women and 33.3% of men), and the majority (63.3% of patients) associated this exacerbation with stress pandemic Exacerbation occurred insignificantly more often in refugees: 38.9% vs. 34.0% (p>0.05); among local residents, the impact of stress was more often noted by women (66.7% vs. 57.1%, p>0.05), and among refugees by men (66.7% vs. 62.5%, p>0.05). The structure of psychopathological manifestations during an exacerbation during the COVID-19 pandemic was dominated by fear and anxiety (80.0%), low mood (66.7%), dyssomnias (50%), manifestations of asthenia (36.7%), emotional lability and irritability (33.3%), with the prevalence of all psychopathological symptoms being slightly higher among women. It was found that the stress of war was associated with a higher frequency of psoriasis exacerbations (49.4%) and a higher association with social stress (82.9%), more significantly in refugees (55.6% vs. 44.7%, p>0, 05), and among men (51.3% vs. 47.7%, p>0.05). This is a significant (p<0.01) more than during the Covid-19 pandemic, the same differences are detected for men (p<0.01) and women (p <0.05). Statistically significant exacerbation occurred after the start of the war compared to the Covid-19 pandemic in IDPs in general (p <0.05) and in men-IVPO (p <0.05). Affected by psychopathological symptoms during exacerbations during wartime was also higher than the pandemic period: fear, anxiety – 97.6%, reduced mood – 92.7%, asthenisation – 51.2%, irritability – 39.0%. Moreover, men were greater than the prevalence of low mood and emotional lability. Conclusion. The determining factor of exacerbation of psychosomatic pathology (on the model of excerbation of psoriasis) is the content of stress factor and features of individual response to stress, while gender differences of response, and even the fact of forced resettle during large-scale social crises, are less significant. The prospects for further research are to study the role of large-scale social crises with the recurrence of psychosomatic pathology, and to develop on the basis of these personalized medical and psychological support measures.