Pathological worrying, illness perceptions and disease severity in patients with psoriasis

Objectives. To investigate the cognitive model of psoriasis held by patients and to explore its relationship with pathological worrying, and with the clinical severity and anatomical location of the patients' psoriasis. Design. Correlational design. Methods. A total of 140 patients with psoriasis attending the University of Manchester's Psoriasis Speciality Clinic at Hope Hospital, Salford underwent a medical examination where the clinical severity of their psoriasis and medical history were assessed by their dermatologist. The Penn State Worry Questionnaire (PSWQ) and the Illness Perception Questionnaire (IPQ) were used to assess worry and illness representations, respectively. Results. Clinical severity of psoriasis was not associated with illness perceptions nor with pathological worry. A logistic regression analysis indicated that pathological worry was associated with stronger beliefs in psoriasis having serious consequences, and stronger beliefs in an emotional cause. Women were also significantly more likely to be members of the pathological worry group. It was found that 38% of the sample scored within one standard deviation of the worry score for patients diagnosed with Generalized Anxiety Disorder. Conclusions. A considerable number of patients with psoriasis experience high levels of worrying thoughts that are linked more to personal and social evaluative concerns than to the pathophysiology or course of their disease.