Resilience To Stress Linked To Risk Of Psoriasis

Psoriasis is a chronic inflammatory systemic disease, and those with psoriasis often have other diseases. Around 30% of those with psoriasis will also develop psoriatic arthritis which is an inflammatory joint disease. It is not fully understood what triggers the disease, but heredity in combination with external factors is thought to play a major role, and the link to stress could be due to an increased inflammatory response in the body. 

This study is based on data from over 1.6 million Swedish men enlisted for military service who underwent psychological assessment at enlistment, in accordance with the same strict process. The data was split into three groups based on resilience to stress with 20.4% of the men being placed in the lowest group, 21.5% were placed in the highest group and the remaining 58.1% were placed in the middle intermediate group. Then, data relating to the men was cross-checked with other registers, and the National Patient Register was used to obtain diagnosis codes for psoriasis and psoriatic joint arthritis. 

The analysis revealed that close to 36,000 of the men went on to develop psoriasis or psoriatic arthritis later in life, and low-stress resilience was found to have a 31% higher risk of developing psoriasis compared to having high-stress resilience. Low-stress resilience meant a 79% higher risk of developing psoriasis and a 53% higher risk of psoriatic arthritis compared to having a high-stress resilience for in-patient diagnosis. Additionally, the more severe cases of psoriasis and psoriatic arthritis were found to be particularly linked to stress. 

“We have shown that lower stress resilience in adolescence is a potential risk factor for psoriasis, at least for men,” says the study’s lead author Marta Laskowski, a doctoral student in dermatology at the University of Gothenburg and a resident physician at Sahlgrenska University Hospital. “Our results suggest that those with psoriasis have a hereditary psychological sensitivity. It is therefore important that healthcare professionals also pay attention to the mental wellbeing of patients with psoriasis.”

“Stress resilience can vary throughout life,” adds Marta. “However, we have not had the opportunity to investigate these changes.”

The results of the study have been published in the Journal of the European Academy of Dermatology and Venereology.