الفهرس 
Acknowledgment
Psoriasis and stressOnly 14 pages are availabe for public view
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Abstract
Psoriasis is an immune mediated genetically determined common dermatological disorder which affects skin, nails, and joints and has various systemic associations. There is evidence that the disease is associated with a high impact on the health-related quality of life and considerable cost (Dogra and Yadav, 2010).
Psoriasis is a persistent, disfiguring and stigmatizing disease(Russo et al., 2004) affecting approximately 2–3% of the general population(Stern et al., 2004). Two-peak age of onset was considered for the disease; the early age of onset is between 16-22 years, and the latent age of onset is between 57-60 years (Griffiths and Barker, 2004).
Psoriasis is associated with a variety of psychological problems. Psoriasis impairs ability in everyday activities requiring use of hands, walking, sitting and standing for long periods of time, occupational performance, sexual activities and sleep. So, considering the psychosocial aspects of the disease is very important in psoriatic patients (Golpour et al., 2012).
A systematic review found that the prevalence of depression in psoriatic patients ranged from 9% to 62%,while the prevalence of anxiety ranged from 11% to 43% (Daudén et al., 2013).
Psychological stress can induce resistance to regular psoriatic treatment and causes psoriasis to appear worse. In this view, psoriasis is an inflammatory disease with expensive and long term therapies, and as mentioned before, psychological stress can exacerbate the disease. So that, recognition and treatment of psychosocial problems can decrease health care costs and shorten the therapeutic period (Bist et al., 2015).
The purpose of this study was to evaluate some of psychiatric disorders especially depression and anxiety among psoriatic patients attending Assiut University Hospital.
This study is a cross-sectional study which included one hundred psoriatic patients (65 males and 35 females) who attended dermatology department (Ultra-Violet Unit and Out-Patient Clinics) of Assiut University Hospital (AUH) from 1-July 2015 to 31- May 2016.
Psoriatic patients had been chosen from both genders, their ages were from 18 to 65 years, had >10 percent BSA (Body Surface Area) involvement, as determined by a dermatology physician using the Psoriasis Area Severity Index (PASI) and an informed consent was obtained from all the patients.
All eligible patients were subjected to the following tools: Beck Depression Inventory (BDI) (Beck et al., 1988), Zung Self-Rating Anxiety Scale (Zung, 1971; Ramirez and Lukenbill, 2008), Psoriasis Disability Index (PDI) (Nijsten et al., 2005) and Short Form-36 Quality of Life Questionnaire (SF-36) (McHorney et al., 1993).
Results show that:
• The overall prevalence of depression was 76% among psoriatic patients, 60% of the patients presented with moderate and severe depression.
• There was a significant negative correlation between depression and quality of life scale in its all subscales (i.e., the increase in the severity of depression among psoriatic patients was associated with a decrease in QOL).
• The overall prevalence of generalized anxiety was 79% among psoriatic patients, 66% of the patients presented with marked to severe and most extreme anxiety.
• There was a significant negative correlation between anxiety and quality of life scale in its all subscales (i.e., the increase in the severity of anxiety among psoriatic patients was associated with a decrease in QOL).
• There was a higher cumulative probability for psoriatic patients with longer duration of psoriasis to have a severe grade of depression and anxiety.
• There was a positive correlation between the severity of psoriasis as determined by a dermatology physician using the Psoriasis Area Severity Index (PASI) and depression/anxiety.
• Psoriasis is a disease with major quality of life impairment comparable to that of serious medical conditions.Female gender and long duration of the disease were found to be risk factors for the occurrence of depression and anxiety in psoriatic patients.