Toward a better understanding of social anxiety and depression in psoriasis patients: The role of determinants, mediators, and moderators

- Self-evaluative salience is related to social anxiety in patients with adult-onset.
- In patients with pre-adult onset, social anxiety is associated with stigmatization.
- Effect of psoriasis on negative body-related emotions is moderated by gender.
- Women had negative body image emotions almost irrespective of the disease severity.

ObjectiveTo determine how and under which conditions psoriasis is related to the psychological impairments, in particular, to social anxiety and depression, the current study tested the interplay of selected factors such as gender, age of onset of psoriasis, cognitive and affective elements of body image, experiences of stigmatization, and patients' subjective perceptions of severity of the disease.MethodsAdult psoriasis patients (N = 193) completed the Appearance Schemas Inventory-Revised, the Stigmatization Scale, the Body Emotions Scale, the Beck Depression Inventory, and the Social Anxiety Questionnaire. The disease severity was defined based on the Body Surface Area (BSA) index.ResultsThe effect of psoriasis on social anxiety was moderated by age of onset: higher severity of the disease was associated with higher levels of social anxiety, but only for patients with pre-adult onset psoriasis. Hierarchical multiple regressions revealed that in patients with adult-onset (≥ 18 years of age) the importance of appearance to one's sense of self-worth was the main contributor to social anxiety, while in patients with pre-adult onset, social anxiety was most strongly related to experiences of stigmatization. Moreover, the results indicated that negative body-related emotions mediated the relationship between severity of the disease and depression. Additionally, the relationship between severity of psoriasis and body image emotions was moderated by gender.ConclusionsFindings significantly extend previous studies by confirming and highlighting the role of age of onset of psoriasis in psychological impairments, and provide more insight into factors that contribute to social anxiety in this group of patients.