Skip to main content

Advertisement

Log in

Dyadic Adjustment, Family Coping, Body Image, Quality of Life and Psychological Morbidity in Patients with Psoriasis and Their Partners

  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Background

Psoriasis is an incurable and chronic disease that includes unpredictable periods of remission and relapse requiring long-term therapy.

Purpose

This paper focuses on the relationship among family coping, psychological morbidity, body image, dyadic adjustment and quality of life in psoriatic patients and their partners.

Method

One hundred and one patients with psoriasis and 78 partners comprised the sample. They were regular users of the Dermatology Service of a Central Northern hospital in Portugal and a private dermatology clinic. Patients with psoriasis were assessed on anxiety, depression, body image, quality of life, dyadic adjustment and family coping. Partners were assessed on the same measures except body image and quality of life.

Results

A positive relationship among dyadic adjustment, psychological morbidity and family coping in patients and their partners was found. Also, patients with lower levels of quality of life had partners with higher levels of depressive and anxious symptoms. Better dyadic adjustment predicted family coping in the psoriatic patient. High levels of dyadic adjustment in patients and low partners’ trait anxiety predicted better dyadic adjustment in partners.

Conclusion

The results highlight the importance of incorporating family variables in psychological interventions in psoriasis’ care, particularly family coping and dyadic adjustment as well as the need for psychological intervention to focus both on patients and partners.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Saraceno R, Griffiths CEM. A European perspective on the challenges of managing psoriasis. J Am Acad Dermatol. 2006;54:S81–4.

    Article  PubMed  Google Scholar 

  2. Cabral MF, Baptista A, Cabrita J, Caetano M, Cardoso R, Cirne de Castro JL, et al. Avaliação Epidemiológica da psoríase moderada a grave em Portugal e Espanha. Psoríase Newsletter 2005; 2.

  3. Griffiths CE, Barker JN. Pathogenesis and clinical features of psoriasis. Lancet. 2007;370:263–71.

    Article  PubMed  CAS  Google Scholar 

  4. Lowes MA, Kikuchi T, Fuentes-Duculan J, Cardinale I, Zaba LC, Haider AS, et al. Psoriasis vulgaris lesions contain discrete populations of Th1 and Th17 T cells. J Invest Dermatol. 2008;128:1207–11.

    Article  PubMed  CAS  Google Scholar 

  5. Zachariae R, Zachariae H, Blomqvist K, Davidsson S, Molin L, Mork C, et al. Quality of life in 6497 Nordic patients with psoriasis. Br J Dermatol. 2002;146(6):1006–16.

    Article  PubMed  CAS  Google Scholar 

  6. Richards HL, Fortune DG, Griffiths CE, Main CJ. The contribution of perceptions of stigmatisation to disability in patients with psoriasis. J Psychosom Res. 2001;50(1):11–5.

    Article  PubMed  CAS  Google Scholar 

  7. Gupta MA, Gupta AK, Schork NJ, Ellis CN. Depression modulates pruritus perception: a study of pruritus in psoriasis, atopic dermatitis and chronic idiopathic urticaria. Psychosom Med. 1994;56(1):36–40.

    PubMed  CAS  Google Scholar 

  8. Fortune DG, Richards HL, Main CJ, Griffiths CEM. Pathological worrying, illness perceptions and disease severity in patients with psoriasis. Br J Health Psychol. 2000;5:71–82.

    Article  Google Scholar 

  9. Gupta MA, Schork NJ, Gupta AK, Ellis CN. Alcohol intake and treatment responsiveness of psoriasis: a prospective study. J Am Acad Dermatol. 1993;28(5 Pt 1):730–2.

    Article  PubMed  CAS  Google Scholar 

  10. Ginsburg IH, Link BG. Feelings of stigmatization in patients with psoriasis. J Am Acad Dermatol. 1989;20:53–63.

    Article  PubMed  CAS  Google Scholar 

  11. Sampogna F, Picardi A, Melchi C, Pasquini P, Abeni D. Prevalence of psychiatric morbidity in patients with psoriasis. Dermatol Psychosom. 2003;4:103–22.

    Article  Google Scholar 

  12. Kossakowska NM, Ciescinska C, Jaszewska CJ, Placek WJ. Control of negative emotions and its implication for illness perception among psoriasis and vitiligo patients. JEADV. 2010;24(4):429–33.

    PubMed  CAS  Google Scholar 

  13. Gupta MA, Gupta AK, Watteel GN. Early onset (<40 years age) psoriasis is comorbid with greater psychopathology than late onset psoriasis: a study of 137 patients. Acta Derm Venereol (Stockh). 1996;76:464–6.

    CAS  Google Scholar 

  14. Rapp SR, Feldman SR, Exum ML, Fleischer AB, Reboussin DM. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol. 1999;41:401–7.

    Article  PubMed  CAS  Google Scholar 

  15. Fouéré S, Adjadj L, Pawin H. How patients experience psoriasis: results from a European survey. JEADV. 2005;19(3):2–6.

    PubMed  Google Scholar 

  16. Kimball AB, Jacobson C, Weiss S, Vreeland MG, Wu Y. The psychosocial burden of psoriasis. Am J Clin Dermatol. 2005;6(6):383–92.

    Article  PubMed  Google Scholar 

  17. Mukhtar R, Choi J, Koo JY. Quality of life issues in psoriasis. Dermatol Clin. 2004;22:389–95.

    Article  PubMed  Google Scholar 

  18. Meyer N, Paul C, Feneron D, Bardoulat I, Thiriet C, Camara C, et al. Psoriasis: an epidemiological evaluation of disease burden in 590 patients. JEADV. 2010;24:1075–82.

    PubMed  CAS  Google Scholar 

  19. Finlay AY. Psoriasis from the patient`s point of view. Arch Dermatol. 2001;137:352–3.

    PubMed  CAS  Google Scholar 

  20. Krueger GG, Feldman SR, Camisa C, Duvic M, Elder JT, Gottlieb AB, et al. Two considerations for patients with psoriasis and their clinicians: What defines mild, moderate, and severe psoriasis? What constitutes a clinically significant improvement when treating psoriasis? J Am Acad Dermatol. 2000;43(2 pt 1):281–5.

    Article  PubMed  CAS  Google Scholar 

  21. Schmid-Ott G, Burchard R, Niederauer HH, Lamprecht F, Künsebeck HW. Stigmatization experience and the quality of life patients with psoriasis and atopic dermatitis. Hautarzt. 2003;54:852–7.

    Article  PubMed  CAS  Google Scholar 

  22. Cash TF, Grant J. Cognitive-behavioral treatment of body-image disturbances. In: Van Hasselt V, Hersen M, editors. Sourcebook of psychological treatment manuals for adult disorders. New York: Plenum Press; 1996. p. 567–614.

    Google Scholar 

  23. Walker C, Papadopoulos L. Psychodermatology: The psychological impact of skin disorders. Cambridge: Cambridge University Press; 2005.

    Google Scholar 

  24. Frangos JE, Kimball AB. Divorce/marriage ratio in patients with psoriasis compared to patients with other chronic medical conditions. J Invest Dermatol. 2008;128 Suppl 1:S87.

    Google Scholar 

  25. Koo J. Population based epidemiologic study of psoriasis with emphasis on quality of life assessment. Psychodermatology. 1996;14(3):485–96.

    CAS  Google Scholar 

  26. Schwartz L, Slater MS. The impact of chronic pain on the spouse: clinical and research implications. Holistic Nurs Pract. 1991;6:9–16.

    CAS  Google Scholar 

  27. Richards HL, Chong SLP, Mason DL, Griffiths CEM. The impact of psoriasis on healthy partners patients with psoriasis. Br J Dermatol. 2002;147(62):40.

    Google Scholar 

  28. Gupta MA, Gupta AK. Psoriasis and sex: a study of moderately to severely affected patients. Int J Dermatol. 1997;36:359–62.

    Google Scholar 

  29. Sampogna F, Gisondi P, Tabolli S, Abeni D. Impairment of sexual life in patients with psoriasis. Dermatology. 2007;214:144–50.

    PubMed  Google Scholar 

  30. Rolland JS. Toward a psychosocial typology of chronic and life threatening illness. Fam Syst Med. 1984;2(3):245–62.

    Article  Google Scholar 

  31. Jerant AF, Von Friederichs-Fitzwater MM, Moore M. Patients’ perceived barriers to active self-management of chronic conditions. Patient Educ Couns. 2005;57:300–7.

    Article  PubMed  Google Scholar 

  32. Kellet S. Shame-focused acne: a biopsychosocial conceptualisation and treatment rationale. In: Gilbert P, Miles J, editors. Body shame: conceptualisation, research and treatment. East Sussex: Brunner-Routledge; 2002. p. 135–54.

    Google Scholar 

  33. Bradley C. Translation of questionnaires for use in different languages and cultures. In: Bradley C, editor. Handbook of psychology and diabetes. A guide to psychological measurement in diabetes research and practice. London: Harwood Academic; 1996.

    Google Scholar 

  34. Finlay AY, Kelly SE. Psoriasis—an index of disability. Scott Med J. 1985;30:266.

    Google Scholar 

  35. Finlay AY, Kelly SE. Psoriasis—an index of disability. Clin Exp Dermatol. 1987;198(12):8–11.

    Article  Google Scholar 

  36. Finlay AY, Khan GK, Luscombe DK, Salek MS. Validation of sickness impact profile and psoriasis disability index in psoriasis. Br J Dermatol. 1990;123:751–6.

    Article  PubMed  CAS  Google Scholar 

  37. Kent G, Al-Abadie M. The Psoriasis Disability Index—further analyses. Clin Exp Dermatol. 1993;18:414–6.

    Article  PubMed  CAS  Google Scholar 

  38. Pereira MG, Brito L. Psoriasis Disability Index—research version. Braga: University of Minho; 2008.

    Google Scholar 

  39. Spanier GB. Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. J Marriage Fam. 1976;38:15–28.

    Article  Google Scholar 

  40. Spanier GB. Improve, refine, recast, expand, clarify—don’t abandon. J Marriage Fam. 1985;47:1073–4.

    Article  Google Scholar 

  41. Busby DM, Christensen C, Crabe DR, Larson JH. A revision of the dyadic adjustment scale for use with distresse and non distressed couples: construct hierarchy and multidimensional scales. J Marital Fam. 1995;21(3):289–308.

    Article  Google Scholar 

  42. Pereira MG. Escala Revista de Ajustamento Diádico (RDAS). Research version. Braga: University of Minho; 2003.

    Google Scholar 

  43. Hopwood P, Fletcher I, Lee A, Al Ghazal S. A body image scale for use with cancer patients. Eur J Cancer. 2001;37:189–97.

    Article  PubMed  CAS  Google Scholar 

  44. Cotrim H, Pereira MG. Imagem Corporal, Morbilidade Psicológica e Qualidade de Vida em Doentes com Cancro Colorectal: Estudos das Características Psicométricas do Body Image Scale. In: Machado C, Almeida L, Guisande M, Gonçalves M, Ramalho V, editors. Livro de Actas da XIII Conferência Internacional Avaliação Psicológica: Formas e Contextos. Braga: University of Minho; 2008. p. 2008.

    Google Scholar 

  45. Spielberger CD, Gorush R, Lushene R, Vagg PR, Jacobs GA. Manual for the State-Trait Anxiety Inventory. Palo Alto: Consulting Psychologists Press; 1983.

    Google Scholar 

  46. McIntyre L, McIntyre S. State Trait Anxiety Inventory (STAI). Research version. Braga: University of Minho; 1995.

    Google Scholar 

  47. Beck A, Steer RA, Brown GK. Manual for the Beck Depression Inventory-II. San Antonio: Psychological Corporation; 1996.

    Google Scholar 

  48. Beck AT, Steen RA, Gabrin MG. Psychometric properties of the Beck. Depression Inventory: twenty-five years of evaluation. Clin Psych Rev. 1988;8:77–100.

    Article  Google Scholar 

  49. McIntyre M, Araújo-Soares V. Inventário da depressão de Beck: Estudo de validade numa amostra de doente com dor crónica. In: Avaliação Psicológica: Formas e Contextos. Braga: Universidade do Minho; 1999. p. 245–55.

    Google Scholar 

  50. Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67(6):361–70.

    Article  PubMed  CAS  Google Scholar 

  51. Brito L, Pereira MG. Morbilidade Psicológica e Imagem Corporal em Doentes com Psoriasis Estudo das Características Psicométricas do HADS. In: Machado C, Almeida L, Guisande M, Gonçalves M, Ramalho V, editors. Livro de Actas da XIII Conferência Internacional Avaliação Psicológica: Formas e Contextos. Braga: University of Minho; 2008.

    Google Scholar 

  52. McCubbin HI, Larsen AS, Olson DH. F-COPES: Family crisis oriented personal evaluation scales. In: McCubbin HI, Thompson HI, editors. Family assessment inventories for research and practice. 2nd ed. Madison: University of Wisconsin-Madison; 1991. p. 203–16.

    Google Scholar 

  53. Mendes F, Relvas AP, Lourenco, MC, et al. Family relationships and primary prevention of drug use on early adolescence. Valencia: IREFREA, European Commission; 1999.

  54. Scharloo M, Kaptein AA, Weinman J, Bergman W, Vermeer BJ, Rooijmans HGM. Patient´s illness perceptions and coping as predictors of functional status in psoriasis: a 1 year follow-up. Br J Dermatol. 2000;142:899–907.

    Article  PubMed  CAS  Google Scholar 

  55. Devrimci-Ozguven H, Kundakci TN, Kumbasar H, Boyvat A. The depression, anxiety, life satisfaction and affective expression levels in psoriasis patients. JEADV. 2000;14:267–71.

    PubMed  CAS  Google Scholar 

  56. Youn JI, Park BS, Kim SD, Suh DH. Characterization of early and late onset psoriasis in the Korean population. J Dermatol. 1999;26:647–52.

    PubMed  CAS  Google Scholar 

  57. Northouse LL, Mood D, Templin T, Mellon S, George T. Couples’ patterns of adjustment to colon cancer. Soc Sci Med. 2000;50(2):271–84.

    Article  PubMed  CAS  Google Scholar 

  58. Basra MKA, Finlay AY. The family impact of skin diseases: the Greater Patient concept. Br J Dermatol. 2007;156(5):929–37.

    Article  PubMed  CAS  Google Scholar 

  59. Eghlileb AM, Davies EEG, Finlay AY. Psoriasis has a major secondary impact on the lives of family members and partners. Br J Dermatol. 2007;156(6):1245–50.

    Article  PubMed  CAS  Google Scholar 

  60. Pistrang N, Barker C, Rutter C. Social support as conversation: analysing breast cancer patient`s interactions with their partners. Soc Sci Med. 1997;45(5):773–82.

    Article  PubMed  CAS  Google Scholar 

  61. D’Ardenne P. The couple sharing long-term illness. Sex Relationsh Ther. 2004;19(3):291–308.

    Article  Google Scholar 

  62. Rosenstrauch P. The effects of relationship-focused coping on inflammatory bowel disease. Dissertation International: Section B: The Sciences and Engineering 2005; vol. 66.

  63. Coyne JC, Smith DAF. Couples coping with myocardial infarction: in a contextual perspective on wive’s distress. J Pers Soc Psychol. 1991;61:404–12.

    Article  PubMed  CAS  Google Scholar 

  64. Duarte S. Pereira MG. (in preparation). Predictors and moderators of quality of life in patients with systemic lupus erythematosus.

  65. Tagkalakis P, Demiri E. A fear avoidance model in facial burn body image disturbance. Ann Burn Fire Dis. 2009;22:203–7.

    CAS  Google Scholar 

  66. Gordon PA, Perrone KM. When spouses become caregivers: counseling implications for younger couples. J Rehab. 2004;70(2):27–32.

    Google Scholar 

  67. Lyons RF, Sullivan MJL, Ritvo PG, Coyne JC. Relationships in chronic illness and disability. Thousand Oaks: Sage; 1995.

    Google Scholar 

  68. Rodrigue JR, Park TL. General and illness-specific adjustment to cancer: relationship to dyadic status and dyadic quality. J Psychosom Res. 1996;40(1):29–36.

    Article  PubMed  CAS  Google Scholar 

  69. Segrin C, Badger T, Dorros SM, Meek P, Lopez AM. Independent anxiety and psychological distress in women with breast cancer and their partners. Psycho-Oncology. 2007;16:634–43.

    Article  PubMed  Google Scholar 

  70. Basto L. Variáveis Psicossociais na Psoríase: Um Estudo com Doentes e seus Parceiros (master thesis). Braga: University of Minho; 2008.

    Google Scholar 

  71. Cutrona CE. Social support as a determinant of marital quality: the interplay of negative and supportive behaviors. In: Pierce GR, Sarason BR, Sarason IG, editors. Handbook of social support and the family. New York: Plenum; 1996. p. 173–94.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Graça Pereira.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pereira, M.G., Brito, L. & Smith, T. Dyadic Adjustment, Family Coping, Body Image, Quality of Life and Psychological Morbidity in Patients with Psoriasis and Their Partners. Int.J. Behav. Med. 19, 260–269 (2012). https://doi.org/10.1007/s12529-011-9174-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12529-011-9174-5

Keywords

Navigation