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Abstract Psoriasis is a common chronic disfiguring disorder of unknown etiology. Psoriatic prevalence in Egypt is about 3%. Much of the care of patients with psoriasis, in the hospital setting, involves devising and implementing topical and systemic therapies. Despite Major improvements in these .therapies and more frequent remissions, many patients still have recurrent or chronic disease activity. In this study, 50 patients with psoriasis, 50 other patients with depression, 50 patients of peptic ulcer and another 50 normal persons were subjected to clinical evaluation and psychometric assessment which include DSM III R scale of stressor events, Toronto Alexithymi scale, Minnesota Multiphasic personably inventory Alexithymic subscale, (MMPI-AS), Hostility and direction of Hostility questionnaire (HDHQ), Eyesnck Personality Questionnaire, scale of psychological meaning of illness and the tenth edition of Present State Examination (PSE 10). All case of peptic ulcer were diagnosed by upper gastrointestinal endoscopy with exclusion of any case of cosophageal or gastric varices. Depression was diagnosed according to ICDIO criteria with exclusion of all cases of psychotic depression and bipolar affective disorders. Cases of psoriasis were diagnosed by senior dermatologist with assessment of its severity according to nine rules with exclusion of cases of psoriatic arthritis. -116- Summary & Conclusion The studied psoriatics and other 3 control groups were matched for age, sex, education and occupation. All the studied persons were 18 years or more. WE found that:- 1- Male and low socioeconomic states were more presented in the studied psoriatics. 2- The Majority of psoriatics reported the existence of low impact stressful events preceding onset or exacerbation of psoriasis. Stress, acute and enduring, is evident in its patho-etiology. 3- The average incubation period (2.4 months) was more prolonged than reported European average incubation time. 4- Severity of stressors, Acute events, (DSMIIIR) was positively correlated with severity of psoriasis (nine Rules). 5- There was negative finding concerning severity 01 stress and incubation time . 6- Psoriatics proved to be significantly introverts and neurotics. They showed high degree on the scale of psychotic ism (as a trait) and on the lie scale (social desirability). 7- Hostility, self-criticism, guilt feeling as well as paranoid hostility are found to be significantly playing role in the dynamics of psoriasis. Hostility is directed towards patients’ self (Intropunitives). 8- The normal persons showed higher hostility 16.7 Compared to western results. -117- Summary & Conclusion 9- Psoriasis group had more, in ability to identify and describe feelings and to distinguish between feelings and body sensations, than normal group, Using TAS. 10- No significant difference between psoriatics and normal group for MMPI.-As. ] ]-Depression group is less alexithymic than Psoriatics using MMPI.- As. __ __ ]2- Higher average total degree alexitymia (TAS) in our normal group 71.5 ±7.22 than western normal people (61.1 - 68.2). ] 3- There was no difference between professionals and other occupations regarding Alexithymia , direction of hostility and manifest hostility. ]4- Reported more guilt and loss feeling with illness. ] 5-We found hazardous effects of psoriasis on the quality of life of patient in the form of moderate to severe limitation of activity (82%) marked loss of capacity for enjoyment (70%) tedium vitae (8%) and active suicide ideation (6%). ]6- Substance abuse was prevailing among good percent (]6%) of cases in their past history, ] 7- Psoriatic showed more significant anxiety, depression and somatization symptoms but non of psoriatics fits any other psychiatric disorder According to reD lOusing PSE 10 . ]8- There was no difference between psoriasis and peptic ulcer except for high degree of obessionality on MSS. ] 9- There was no qualitative difference between psoriasis and depressed patients regarding studied factors .. -118- Summary & Conclusion Recommendations * Studying the transcultural factors in cases of psoriasis as well as other psychosomatic disorders. * Providing educational programmes, teaching the proper ways of dealing wich stressors and expressing and communicating feelings. * Providing different psychiatric services to patients with psychosomatic disorders. |